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Background: Intestinal carcinoid tumors are well-differentiated neuroendocrine tumors that are capable of secreting bioactive hormones and/or amines; These tumors are uncommon but are the most common primary tumors of the small intestine. Case presentation: We report the case of an 80-year-old woman who presented with a long history (about 14 years ago) of atypical digestive symptoms such as vague abdominal pain, alternating diarrhea, and constipation, treated as functional colopathy without improvement, until the day when she presented with worsening pain that prompted her consultation. CT scan revealed typical manifestations of a carcinoid tumor associated with signs of subacute small bowel ischemia. Despite the surgery being considered a gold standard treatment, it was rejected due to the extent of tumor mesenteric involvement, therefore, the patient received only somatostatin treatment. Conclusion: Small bowel carcinoid tumors are rare, with typical imaging features based on cross-sectional imaging (CE CT/MRI). Intestinal ischemia is a well-known complication that can be a factor in mortality.

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Introduction: The standard gold treatment of primary hyperparathyroidism (PHP) is parathyroidectomy. Imaging in particular, cervical ultrasound (US) and technetium-99 m- méthoxyisobutylisonitrileparathyroid scintigraphy using the single-photon emission computed tomography (TC-99 m-MIBI-SPECT) are always indicated prior to parathyroid surgery, allowing the location of parathyroid adenomas. The objective of our study is to evaluate the contribution of TC-99 m-MIBI-SPECT and US in the preoperative topographic diagnosis of PHP. Materials and Methods: this is a descriptive and analytical retrospective study, conducted in our department of Endocrinology, Diabetology and Metabolic Diseases in Hassan II University Hospital of Fez between 2009 and 2018. All patients who received a para-thyroidectomy for PHP were recruited. All patients had received a cervical US and a TC-99 m-MIBI-SPECT. We compared imaging data before surgery with data from intraoperative exploration and anatomopathological findings of surgical samples. Results: Forty-eight patients were collected. US correctly identified parathyroid adenoma in 85.40% of patients with PHP versus 89.50% in TC-99 m-MIBI-SPECT. US correctly predicted surgical outecomes in 97.60% of patients and TC-99 m-MIBI-SPECT in 97.72% of cases. Their combination had better results in sensitivity and positive predictive value. Conclusion: TC-99 m-MIBI-parathyroid scintigraphy SPECT had a higher probability for solitary parathyroid adenoma compared to cervical US. Its use coupled with the TC-99 m-MIBI-parathyroid scintigraphy SPECT allows reliable preoperative tracking.

RésuméIntroduction: Le gold standard du traitement de l'hyperparathyroïdie primaire (HPTP) est la parathyroïdectomie. Afin de localiser l'adénome parathyroïdien avant la chirurgie, Le bilan topographique fait appel à l'échographie cervicale et à la scintigraphie parathyroïdienne au technetium-99 m-méthoxyisobutylisonitrile(TC-99m-MIBI-SPECT).L'objectif de notre étude est d'évaluer la contribution du TC-99 m-MIBI-SPECT et de l'échographie au diagnostic topographique préopératoire de HPTP. Matériels et méthodes: Il s'agit d'une étude rétrospective descriptive et analytique, menée dans notre département d'Endocrinologie, Diabétologie et Maladies métaboliques au CHU Hassan II de Fès entre 2009 et 2018. Tous les patients ayant subi une para-thyroïdectomie pour des HPTP ont été recrutés. Tous les patients avaient bénéficié d'une échographie cervicale et une scintigraphie au TC - 99 m - MIBI - SPECT. Nous avons comparé les données d'imagerie avant la chirurgie avec les données issues de l'exploration peropératoire et les résultats de l'étude anatomopathologique des échantillons chirurgicaux. Résultats: on a inclus quarante-huit patients. l'adénome parathyroïdien était correctement identifié chez 85,40% des patients à l'échographie cervicale contre 89,50% à la scintigraphie au TC - 99 m - MIBI - SPECT. l'échographie cervicale avait prédit correctement les résultats chirurgicaux chez 97,60% des patients contre 97,72% à la scintigraphie au TC - 99 m - MIBI - SPECT. Leur combinaison avait une meilleure sensibilité et une meilleure valeur prédictive positive. Conclusion: la scintigraphie parathyroïde auTC - 99 m - MIBI - SPECT avait une probabilité plus élevée les adénomes parathyroïdiens solitaires par rapport à l'échographie cervicale. Son utilisation couplée à la scintigraphie parathyroïde TC-99 m-MIBI- SPECT permettait une localisation préopératoire plus fiable. Mots-clés: échographie cervicale, valeur prédictive positive, hyperparathyroïdie primaire, scintigraphie parathyroidienne au technétium-99m - méthoxyisobutylisonitrileparathyroïde à l'aide de la tomodensitométrie par émission de photons uniques.

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The paediatricians rely primarily scintigraphic examinations in two situations: when they need functional information to decide operation (measurement of separate function of each kidney for example) or when they want to know if a bone disease is involved, in front of a sudden onset of musculoskeletal disorder. Kidney and bone scan represent 85% of applications for examinations. Some scintigraphic examinations have an essential role in the therapeutic evaluation and staging of malignancies such as MIBG-123 scintigraphy in neuroblastoma and FDG-18F scintigraphy in lymphoma. This presentation would not be complete without mentioning some tests whose indications in children are different from adults like the lung scan that evaluates separate functions of both lungs in diseases such as lung malformations and thyroid scintigraphy performed in cases of congenital hypothyroidism to determine the mechanism of this disease. Finally, to locate a Meckel's diverticulum in front of a gastrointestinal bleeding. Because of its indications, pediatric nuclear medicine concerns a high proportion of very young children, and must take into account the specificities of this age.

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