Ann Thorac Surg 2002;73:1693-1694
© 2002 The Society of Thoracic Surgeons
Correspondence
Neuroendocrine tumors of the lung and octreotide scintigraphy: reply
Eduardo A. Tovar, MDa
a Department of Cardiothoracic Surgery, University of California, Irvine Medical Center, 100 E Valencia Mesa Dr, Suite 301, Fullerton, CA 92835, USA
e-mail: etovarmd{at}aol.com
To the Editor
Filosso and colleagues reemphasize the value of the Octreoscan in detecting primary neuroendocrine tumors of the lung as well as their mediastinal and distant metastases. Of particular interest, as they point out, is the diagnosis of mediastinal involvement in patients with negative computed tomographic scans. However, because the great majority of primary neuroendocrine tumors of the lung are diagnosed postoperatively, the preoperative use of this study remains limited.
Approximately 2 years ago, I saw a patient with a suspected bronchial carcinoid with no mediastinal lymphadenopathy on computed tomographic scan. Right upper lobectomy and mediastinal lymphadenectomy were performed guided by the Octreoscan findings. Pathological T1, N2 disease was confirmed. Follow-up Octreoscans have remained negative. Systematic use of Octreoscans should become the standard of care for all patients with biopsy-proven neuroendocrine tumors of the lung. In addition, this study should be the core of the surveillance for recurrence in follow-up of these patients. We should keep in mind, however, that OctreoScans are almost as expensive as 187-fludeoxyglucose-positron emission tomographic scans, and we must use them judiciously.
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