doiSerbia

18F-FDG PET/CT “hepatic superscan” in incomplete Carney’s triad

Zivgarević Ljiljana (Clinical Center of Serbia, Center of Nuclear Medicine, National PET Center, Belgrade, Serbia)
Kozarević Nebojša (Clinical Center of Serbia, Center of Nuclear Medicine, National PET Center, Belgrade, Serbia)
Žunić Svetlana (Clinical Center of Serbia, Center of Nuclear Medicine, National PET Center, Belgrade, Serbia)

Introduction. Carney triad is a rare non-hereditary condition characterized by gastrointestinal stromal tumors – intramural mesenchymal tumors of the gastrointestinal tract with neuronal or neural crest cell origin, pulmonary chondromas, and extra-adrenal paragangliomas. The term incomplete Carney triad more precisely refers to the occurrence of at least two of these tumor types. Carney triad named after J. Aidan Carney is considered to be a specific type of multiple endocrine neoplasia. Less than 30 cases of complete and less than 100 cases of incomplete Carney triad have been reported worldwide. Carney triad primarily affects young women (mean age of onset of 20 years). Case outline. A 35-year-old female patient had an initial presentation at the National PET Center, Clinical Center of Serbia, after the gastrectomy, with multiple hepatic metastases as well as bilateral pulmonary chondromas. 18F-FDG PET/CT scan revealed the following: 1) intense 18F-FDG uptake in the liver metastatic lesions, with reduced physiological activity in the brain and heart, bowel, and renal tracer uptakes commonly known as FDG hepatic superscan; 2) multiple irregular-shaped lesions, mostly calcified in bilateral pulmonary parenchyma; 3) a nodular lesion in the left adrenal gland with accumulation of 18F-FDG in its anterior part. Conclusion. The present study describes a hepatic superscan in a patient with incomplete Carney triad, including gastrointestinal stromal tumors and pulmonary bilateral chondromas, as well as a tumor in the left adrenal gland.

Keywords: GIST, 18F-FDG PET/CT, hepatic superscan, Carney triad, tartrate-resistant acid phosphatase