Case Author(s): Jeff A. Chesnut, D.O. and Henry Royal, M.D. , 6/24/99 . Rating: #D2, #Q4

Diagnosis: Meningioma

Brief history:

64 year old female being evaluated for elevated gastrin levels and recurrent peptic ulcers.


Whole body images from octreotide scintigram are shown.

View main image(ot) in a separate image viewer

View second image(ot). Isolated view of the head - octreotide scintigram.

View third image(mr). Coronal MRI image of the brain is shown.

View fourth image(mr). Coronal MRI of the brain with pointer.

Full history/Diagnosis is available below

Diagnosis: Meningioma

Full history:

64 year old female with Zollinger-Ellison syndrome and a gastrin level above 500. Being evaluated for gastrinoma.


In-111 pentetreotide


The 24 hr. whole-body scintigrams reveal no evidence of gastrinoma. There is intense increased activity near the left skull base, however.


Octreotide is used for the detection of somatostatin receptor positive tumors. This study reveled an incidental focus of increased activity in the head. Among the more common causes of activity in the head during octreotide scintigraphy are metastases from somatostatin positive tumors, meningiomas, well-differentiated astrocytomas (but not in undifferentiated glioblastomas), and in pituitary adenomas.


The patient had a history of a long-standing, stable meningioma adjacent to the left cavernous sinus. Her previous MRI studies were obtained and the meningioma was demonstrated to correspond with the increased activity on the octreoscan image.

Major teaching point(s):

A number of tumors may cause increased octreotide activity in the head.

Differential Diagnosis List

1. Metastasis from a somatastatin receptor positive tumor.

2. Meningioma

3. Well-differentiated astrocytoma

ACR Codes and Keywords:

References and General Discussion of Octreotide Scintigraphy (Anatomic field:Skull and Contents, Category:Neoplasm, Neoplastic-like condition)

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Case number: ot005

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