Head Pancreatic Carcinoma and D Mellitus
Male patient 69 year old, diabetic under insulin with a history of pancreatic
tumor. MRI: mild splenomegaly,
bilateral perirenal edema; simple cyst left kidney. Abdominal CT: ill-defined small image in pancreatic head. Myelogram:
no evidence of malignant cell infiltration. Gastric endoscopy antrum
erosive gastritis; hiatal hernia. Colonoscopy: no obvious lesions. CA 19-9: 7980 U / mL
(N <39; CA 125 : 640 U / mL
(N <35). CEA: 6.8 ng / mL (N <3.4). PET
FDG Dose: 17 mCi, injected with glucose of 120 mg / dL post injection of 5 U of
insulin (due to abnormal basaline glucose of 261 mg / dL). F18FDG-PET shows a focus of increased uptake of FDG moderate epigastric in projection
site of the pancreatic head, 2.8 cm in diameter approx (arrow). Diffuse increased tracer activity in muscles
and the heart explained
by use of insulin, which may eventually reduce the uptake in other malignant
lesions. It might be better to control adequately the diabetes before doing the
PET F18FDG scan not to affect the sensitivity of the study.
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