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Intraoperative Detection of a Bronchial Carcinoid With a Radiolabeled Somatostatin Analog*

Jaime A. Rodriguez, MD; Michael O. Meyers, MD; Tomas H. Jacome, MD; Paul Failla, MD, FCCP; Lynn H. Harrison, Jr, MD, FCCP
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*From the Department of Surgery (Drs. Rodriguez, Meyers, and Jacome), Section of Cardiothoracic Surgery (Dr. Harrison), and Department of Medicine (Dr. Failla), Section of Pulmonary Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.

Correspondence to: Lynn H. Harrison, Jr, MD, FCCP, Professor of Surgery, Chief, Division of Cardiothoracic Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Ave, Suite 701, New Orleans, LA 70112; e-mail: LHARRI@LSUHSC.edu



Chest. 2002;121(3):985-988. doi:10.1378/chest.121.3.985
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Carcinoid tumors of the lung are rare neuroendocrine tumors that make up approximately 1 to 2% of all lung neoplasms. These tumors overexpress somatostatin receptors, and somatostatin analog therapy has become standard in the treatment of carcinoid tumors. In addition, radiolabeled somatostatin analogs have been used to diagnose and treat these lesions. We describe the case of a patient with a right lung mass diagnosed as a carcinoid tumor. The patient underwent complete resection of this tumor with the assistance of intraoperative detection with a handheld gamma probe after the administration of the radiolabeled somatostatin analog 111In-pentetreotide. This approach allowed us not only to detect the tumor easily, but to scan the bed of the tumor after resection and to re-excise an area of increased radioisotope uptake that corresponded to the presence of residual tumor. We believe this to be the first reported case of bronchial carcinoid resected with the assistance of intraoperative gamma detection after the administration of a radiolabeled somatostatin analog. This technology allowed us to achieve a complete surgical resection with no residual tumor detected either pathologically or by somatostatin scanning.

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