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Accumulation of gallium-67 within mature and immature teratoma in pediatric patients: investigation for the uptake mechanism

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Abstract

Objective

We encountered cases of mature and immature teratoma with positive uptake of 67Ga. The objective of this study is to investigate the mechanism of 67Ga accumulation within mature and immature teratomas by comparing the findings of gallium scan, computed tomography (CT), and autoradiography of surgical specimens with the pathological findings.

Methods

The subjects comprised 14 children who underwent surgical resection for intra-abdominal mature and immature teratomas, which were histologically proved to be of the mature and immature subtype. Their age ranged from 24 days to 14 years. The origins of the mature teratomas consisted of seven ovaries including one bilateral case, two retroperitoneal, and two sacrococcygeal regions. The origins of the immature teratomas were retroperitoneum in two cases, an ovary and a sacrococcygeal region. Complete surgical excision was feasible in all children. They underwent both gallium scan and CT prior to surgery. Single-photon emission computed tomography was added in some cases. For two gallium-positive cases, radiography and scintigraphy (autoradiography) of the resected specimen were performed.

Results

Of the 14 children, 5 (one with immature and four with mature subtype) showed positive 67Ga uptake within tumors, which originated from the retroperitoneum in the 3 boys, and from the ovary in the 2 girls. All had typical CT findings of teratoma, including calcifications, fat components, cystic areas, and solid parts. 67Ga accumulation in the four mature teratomas appeared discretely strong, and was considered to correspond with intralesional calcifications. However, in the remaining one immature teratoma, the gallium distribution was diffuse within the tumor. The comparison between radiography and autoradiography of the resected mature teratomas confirmed the correlation between the intralesional calcifications and areas of 67Ga accumulation.

Conclusions

A high-uptake ratio of 67Ga in benign teratoma was indicated. A close correlation between gallium scan and CT helps to ascertain whether 67Ga uptake results from malignant and/or immature elements, or mature tissue components.

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Authors and Affiliations

  1. Department of Radiology, Tokyo Metropolitan Kiyose Children’s Hospital, Kiyose, Tokyo, Japan

    Etsuo Kunieda

  2. Department of Radiology, Keio University, Shinjuku-ku, Tokyo, 160-8582, Japan

    Etsuo Kunieda & Atsushi Kubo

  3. Department of Radiology, Kawaguchi Municipal Hospital, Kawaguchi, Saitama, Japan

    Hiroko Hara

  4. Department of Pathology, Tokyo Metropolitan Kiyose Children’s Hospital, Kiyose, Tokyo, Japan

    Yukihiko Morikawa

  5. Department of Surgery, Tokyo Metropolitan Kiyose Children’s Hospital, Kiyose, Tokyo, Japan

    Seiichi Hirobe & Shoichiro Kamagata

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  1. Etsuo Kunieda
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  2. Hiroko Hara
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  3. Yukihiko Morikawa
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  4. Seiichi Hirobe
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  5. Shoichiro Kamagata
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  6. Atsushi Kubo
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Correspondence to Etsuo Kunieda.

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Kunieda, E., Hara, H., Morikawa, Y. et al. Accumulation of gallium-67 within mature and immature teratoma in pediatric patients: investigation for the uptake mechanism. Ann Nucl Med 22, 207–213 (2008). https://doi.org/10.1007/s12149-007-0095-y

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  • DOI: https://doi.org/10.1007/s12149-007-0095-y

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