Gastric Neuroendocrine Tumors in MEN1 Syndrome: Cinematic Rendering
Jun 2018, Vol. 287: 748, https://doi.org/10.1148/radiol.2018180293 Linda C. Chu, Elliot K. Fishman
A 70-year-old woman with history of multiple endocrine neoplasia 1 (MEN1) syndrome, as manifested by hyperparathyroidism, prolactinoma, adrenal adenoma, pancreatic neuroendocrine tumors, and multiple gastric neuroendocrine tumors. The patient had previously undergone multiple resections of small gastric neuroendocrine tumors. Her recent laboratory results showed elevated serum serotonin of 376 ng/mL, elevated serum chromogranin A of 2320 ng/mL, and elevated serum gastrin of 894 pg/mL. Intravenous contrast material–enhanced CT images postprocessed with cinematic rendering in sagittal orientation show (a) multiple enhancing gastric polyps (arrows) and (b) diffuse gastric fold thickening (arrows), compatible with recurrent gastric neuroendocrine tumors. Cinematic rendering is a recently described three-dimensional rendering technique that generates photorealistic images based on a new lighting model. Cinematic rendering improved depth perception, which increased conspicuity of these subtle mucosal lesions. These CT findings were stable compared with prior examinations. The patient was treated with proton pump inhibitors and remained essentially asymptomatic.