Paraneoplastic PET/CT Frequency

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Jublybubly81

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Hi I posted on another forum and had some great replies that has made me even more intrigued about paraneoplastic syndromes. I am guessing that the return of PET/CT to try and locate a possible underlying tumor diminishes over time. Weighing up the cons of repeated radiation exposure, when do people generally accept that they can rule out malignancy. I have not found anything definitive. Complex area, room for lots of confusion.

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Malignancy can rarely be truly ruled out in these cases. I've been involved in several cases where the antibody profile was near 100% certain to represent PNP but a primary could never be found despite extremely extensive workup.
 
Malignancy can rarely be truly ruled out in these cases. I've been involved in several cases where the antibody profile was near 100% certain to represent PNP but a primary could never be found despite extremely extensive workup.
Thanks, this helps me appreciate why neurology was involved in the case and recommended follow ups. Hard trying to get my head around this and justify to others.
How long did the paraneoplastic go on for in your cases and did you suspect a particular malignancy?
Thanks.
 
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Usually paraneoplastic syndromes where a primary tumor isn't resectable don't respond to treatment at all, or if they do the effect (of steroids, PLEX, etc) tends to be transient. The patients in the cases I'm thinking of were made comfort care after a very modest and short lived response to treatment.
 
Thanks again Thama, you are the first person I've heard from that has actually come into contact with this. Spoke to a couple of people where they suspected paraneoplastic, but imaging was clear and they said follow up in excess of 3 years never revealed anything, so the cases always remained a possibility rather than a diagnosis. This is yet another area where reading any text book cannot replace experience. And I guess, until you experience it, you will always have a bit of a doubt.
Thanks.
 
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