Carcinoid tumor of the appendix.PET scan results

Posted by riffieli @riffieli, Dec 21, 2022

Hi everyone i was diagnosed w a carcinoid tumor of the appendx. It was removed 8 m again along w my rt colon.
Fast forward I had a pet scan and this is what it show. I am scared and would appreciate all the help. Do you think I have metastasis?
EXAM: NM PET/CT CU64 DOTATATE

DATE: 12/9/2022

INDICATION: Appendiceal well-differentiated neuroendocrine tumor.

ADDITIONAL HISTORY: As per medical chart, Appendiceal well-differentiated neuroendocrine tumor, stage II pT3NxM0. 2/10/2022: S/P robotic?appendectomy. 3/28/22: S/P laparoscopic rt hemicolectomy. Thyroid, left middle, fine needle aspiration; smears and
thin prep: Benign follicular nodule with cystic change.

TECHNIQUE: The patient was intravenously injected with 4.60 mCi of Cu-64 Dotatate via a right antecubital vein at 8:20. PET/CT scanning began at 9:44. Patient weight was reported as 70.76 kg. Images were acquired from the skull base to the upper thighs.
The low-dose noncontrast CT data was used for attenuation correction and anatomic localization. Reconstructed images in the axial, sagittal and coronal views were interpreted. Quantitation was performed using maximum standardized uptake values (SUVmax).

COMPARISON: FDG PET/CT dated 7/7/2021.

CORRELATION: CT abdomen on 3/1/2022 and MR abdomen on 1/31/2022.

FINDINGS:

Background hepatic activity: SUV 8.6.
Background splenic activity: SUV 26.6.

Head/Neck:
There is physiologic distribution of the radiotracer in the imaged portions of the head and neck. No radiotracer avid cervical lymphadenopathy.

There is focal increased radiotracer uptake in the left thyroid gland, SUV 4.1, corresponding to a 1.3 cm hypoattenuating nodule.

There is mild ethmoid and maxillary sinus mucosal thickening.

Chest:
There is physiologic distribution of the radiotracer within the chest without suspicious radiotracer avid mediastinal, hilar or axillary lymphadenopathy. There is mild residual thymic tissue in the anterior mediastinum.

Limited assessment of the lungs due to low dose, thick slice, low lung volume technique obtained during shallow breathing demonstrates atelectatic changes at the lung bases. There are no radiotracer avid pulmonary nodules identified. There is no
pericardial or pleural effusion.

Abdomen/Pelvis:
Postsurgical changes of right hemicolectomy without suspicious radiotracer uptake within the operative bed.

There is focal radiotracer uptake in the gallbladder fossa/gallbladder SUV 12.1 which may represent physiologic excretion, however attention on follow-up is recommended. Allowing for this there is no focal suspicious radiotracer uptake within the liver.

There is no abnormal radiotracer uptake within the spleen, pancreas or adrenal glands.

Physiologic activity is seen within the renal collecting systems, ureters and urinary bladder which limits assessment for focal underlying radiotracer avid lesions in these areas.

There is variable nonspecific radiotracer uptake throughout the bowel.

There is no suspicious radiotracer avid lymphadenopathy in the abdomen or pelvis. There are subcentimeter inguinal lymph nodes with mild radiotracer uptake, SUV 1.6, likely reactive in nature.

Musculoskeletal:
There is no abnormal radiotracer activity seen within the osseous structures. There is asymmetric focal uptake in the posterior right iliac bone, SUV 2.8, without definite CT correlate.

Interested in more discussions like this? Go to the Neuroendocrine Tumors (NETs) Support Group.

Hi @riffieli, It looks like you may have received the results of you PET scan before an appointment with your doctor to discuss what this means for you. This can cause a lot of anxiety. Members here on this forum can support you as you wait for your upcoming appointment. They know first hand what it's like to be worried about test results.

Your doctor is the person equipped to interpret these results along with your medical history and any other tests you've had done.

When is your upcoming appointment to discuss the results? Was the PET scan ordered as a routine follow-up? When did you have surgery?

REPLY
@colleenyoung

Hi @riffieli, It looks like you may have received the results of you PET scan before an appointment with your doctor to discuss what this means for you. This can cause a lot of anxiety. Members here on this forum can support you as you wait for your upcoming appointment. They know first hand what it's like to be worried about test results.

Your doctor is the person equipped to interpret these results along with your medical history and any other tests you've had done.

When is your upcoming appointment to discuss the results? Was the PET scan ordered as a routine follow-up? When did you have surgery?

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I had my first surgery 8 months ago. My Oncologist was busy so I spoke to a nurse practitioner that I didn’t even know. I basically told her what it is. It is disaster!! Then after I told her she spoke to the dr called me back and said your Dr ordered an MRI of liver and right hip. So waiting to do that next Thursday. But in the mean time I’m trying to get answers. Btw I appreciate you responding

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Hello @riffieli

Your concerns are understandable. I have had three surgeries for NETs in the upper digestive tract and from my understanding, an MRI is the best way to view the liver. I have an MRI done every other year to view both pancreatic cysts and the liver. The cysts were originally found on a CT scan, but I was told that the MRI was the best way to picture the liver and pancreas.

It is best not to get overly worried (I know that this is easier said than done). Until you get more clarification from the MRI results, try to relax and do something to get your mind off of the upcoming tests.

I look forward to hearing from you again. Will you continue to post as you have questions or concerns?

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@hopeful33250

Hello @riffieli

Your concerns are understandable. I have had three surgeries for NETs in the upper digestive tract and from my understanding, an MRI is the best way to view the liver. I have an MRI done every other year to view both pancreatic cysts and the liver. The cysts were originally found on a CT scan, but I was told that the MRI was the best way to picture the liver and pancreas.

It is best not to get overly worried (I know that this is easier said than done). Until you get more clarification from the MRI results, try to relax and do something to get your mind off of the upcoming tests.

I look forward to hearing from you again. Will you continue to post as you have questions or concerns?

Jump to this post

Ty so much.

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@riffieli

I had my first surgery 8 months ago. My Oncologist was busy so I spoke to a nurse practitioner that I didn’t even know. I basically told her what it is. It is disaster!! Then after I told her she spoke to the dr called me back and said your Dr ordered an MRI of liver and right hip. So waiting to do that next Thursday. But in the mean time I’m trying to get answers. Btw I appreciate you responding

Jump to this post

I completely understand your frustration over the lack of knowledge about these tumors. My husbands local oncologist did not understand basic facts about diagnosis and treatment of them. Fortunately, there is a nearby university hospital takes the time to work with us and determine next best steps; he is scheduled for surgery soon. His is a nonfunctional pancreatic NET.

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Hello, @riffieli

Thank you for sharing this with us and let me tell you this, no matter what your situation is, don’t stress yourself out, you are not alone. When i was diagnosed with small bowel carcinoma, pT4N2MO stage lll, i was researching and read day and night looking for the information regarding my diagnosis. I am not a doctor but I don’t think you should worry much. Your report shows you have well differentiated tumor (which is very slow growing ), stage II pT3NxM0. You are in stage ll , which is also not bad , and MO indicated no distant metastasis, according to your report. The doctor will tell you more but that’s from my experience and little research that i have doing. Just relax, you will be fine!

REPLY
@wifey2021

I completely understand your frustration over the lack of knowledge about these tumors. My husbands local oncologist did not understand basic facts about diagnosis and treatment of them. Fortunately, there is a nearby university hospital takes the time to work with us and determine next best steps; he is scheduled for surgery soon. His is a nonfunctional pancreatic NET.

Jump to this post

So sad what the medical field has become.

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@queensmom

Hello, @riffieli

Thank you for sharing this with us and let me tell you this, no matter what your situation is, don’t stress yourself out, you are not alone. When i was diagnosed with small bowel carcinoma, pT4N2MO stage lll, i was researching and read day and night looking for the information regarding my diagnosis. I am not a doctor but I don’t think you should worry much. Your report shows you have well differentiated tumor (which is very slow growing ), stage II pT3NxM0. You are in stage ll , which is also not bad , and MO indicated no distant metastasis, according to your report. The doctor will tell you more but that’s from my experience and little research that i have doing. Just relax, you will be fine!

Jump to this post

I’m worried about the gallbladder up take and the rt hip uptake

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I appreciate all your comments btw!!! Ty.

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@riffieli

I appreciate all your comments btw!!! Ty.

Jump to this post

Hello @riffieli,

Thinking about you and wondering, have you had the MRI yet? Feel free to post any questions you might have when the results come back.

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