TY  - JOUR
A1  - Baur, Johannes
A1  - Schedelbeck, Ulla
A1  - Pulzer, Alina
A1  - Bluemel, Christina
A1  - Wild, Vanessa
A1  - Fassnacht, Martin
A1  - Steger, U.
T1  - A case report of a solitary pancreatic metastasis of an adrenocortical carcinoma
JF  - BMC Surgery
N2  - Background
Solitary metastases to the pancreas are rare. Therefore the value of resection in curative intention remains unclear. In the literature there are several promising reports about resection of solitary metastasis to the pancreas mainly of renal origin.

Case presentation
Here we report for the first time on the surgical therapy of a 1.5 cm solitary pancreatic metastasis of an adrenocortical carcinoma. The metastasis occurred almost 6 years after resection of the primary tumor. A partial pancreatoduodenectomy was performed and postoperatively adjuvant mitotane treatment was initiated. During the follow-up of 3 years after surgery no evidence of tumor recurrence occurred.

Conclusion
Resection of pancreatic tumors should be considered, even if the mass is suspicious for metastatic disease including recurrence of adrenocortical cancer.
KW  - surgical treatment
KW  - adrenocortical
KW  - carcinoma metastases to pancreas
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-126130
VL  - 15
IS  - 93
ER  - 
TY  - JOUR
A1  - Bluemel, Christina
A1  - Linke, Fraenze
A1  - Herrmann, Ken
A1  - Simunovic, Iva
A1  - Eiber, Matthias
A1  - Kestler, Christian
A1  - Buck, Andreas K.
A1  - Schirbel, Andreas
A1  - Bley, Thorsten A.
A1  - Wester, Hans-Juergen
A1  - Vergho, Daniel
A1  - Becker, Axel
T1  - Impact of \(^{68}\)Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy
JF  - EJNMMI Research
N2  - Background

Salvage radiotherapy (SRT) is clinically established in prostate cancer (PC) patients with PSA persistence or biochemical relapse (BCR) after prior radical surgery. PET/CT imaging prior to SRT may be performed to localize disease recurrence. The recently introduced \(^{68}\)Ga-PSMA outperforms other PET tracers for detection of recurrence and is therefore expected also to impact radiation planning.

Forty-five patients with PSA persistence (16 pts) or BCR (29 pts) after prior prostatectomy, scheduled to undergo SRT of the prostate bed, underwent \(^{68}\)Ga-PSMA PET/CT. The median PSA level was 0.67 ng/ml. The impact of \(^{68}\)Ga-PSMA PET/CT on the treatment decision was assessed. Patients with oligometastatic (≤5 lesions) PC underwent radiotherapy (RT), with the extent of the RT area and dose escalation being based on PET positivity.

Results

Suspicious lesions were detected in 24/45 (53.3 %) patients. In 62.5 % of patients, lesions were only detected by 68Ga-PSMA PET. Treatment was changed in 19/45 (42.2 %) patients, e.g., extending SRT to metastases (9/19), administering dose escalation in patients with morphological local recurrence (6/19), or replacing SRT by systemic therapy (2/19). 38/45 (84.4 %) followed the treatment recommendation, with data on clinical follow-up being available in 21 patients treated with SRT. All but one showed biochemical response (mean PSA decline 78 ± 19 %) within a mean follow-up of 8.12 ± 5.23 months.

Conclusions

\(^{68}\)Ga-PSMA PET/CT impacts treatment planning in more than 40 % of patients scheduled to undergo SRT. Future prospective studies are needed to confirm this significant therapeutic impact on patients prior to SRT.
KW  - prostate cancer
KW  - salvage radiotherapy
KW  - PSMA
KW  - PET/CT
KW  - recurrence
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-147798
VL  - 6
IS  - 78
ER  -