Pancreatic duct cell carcinoma with positive In-111 octreotide uptake

Duct cell adenocarcinomas may produce neuroendocrine markers such as pancre atic polypeptide, gastrin and gastrin releasing hormones. A 53 year old pat ient, with a history of insulin dependent diabetes, was found to have a pan creatic mass which was later pathologically demonstrated to be a duct cell adenocarcinoma. The tumor produced elevated circulating neuroendocrine mark ers specifically gastrin and pancreatic polypeptides. An In-111 Octreotide imaging showed definite uptake of Octreotide by the tumor. The patient was subsequently treated with Somatostatin analog which resulted in the reducti on of some of the circulating endocrine markers. The patient had essentiall y six months of asymptomatic clinical remission but then she relapsed. Octr eotide scanning could be useful for selected patients with pathologic diagn osis of duct cell adenocarcinoma, because some tumors may have neuroendocri ne features and can be imaged, and might even respond to Somatostatin analo g therapy.