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Case Report

Pak J Nucl Med. 2013; 3(1): 73-77

Mediastinal spread of medullary thyroid carcinoma imaged by locally formulated 99mTc- DMSA (V)

Aakif Ullah Khan, Hameedullah, Aamir Bahadur, Muhammad Rauf Khattak, Abdus Saeed Shah.

Medullary thyroid carcinoma (MTC) is a distinct C-cell tumour of the thyroid gland that produces calcitonin in high quantities. Various imaging techniques are available in nuclear medicine to image MTC which include 131I-MIBG and somatostatin receptor imaging agent 111In-Octreotide.Due to the nonavailability of these agents in Pakistan, we tried using locally prepared 99mTc-labelled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) in a patient suspected of advanced MTC. CT with contrast could not be performed in this patient due to raised serum urea and creatinine levels indicating renal impairment. 99mTc(V)-DMSA was prepared by modification of a locally formulated kit of renal DMSA. Significant accumulation of the tracer was seen in the gross disease present in the neck and mediastinum. The resolution and good physical characteristics of 99mTc(V)-DMSA make it a useful agent for MTC imaging, where other modalities are not available.

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