Incidental 68Ga -DOTATATE Uptake in Metastatic Clear Cell Renal Cell Carcinoma: A Case Report

Abstract 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) is a more accurate way to distinguish neuroendocrine tumors compared with conventional diagnostic methods and a standard impressive way to evaluate disease entities. This is based on 68Ga-DOTATATE affinity to somatostatin receptors that are overexpressed in the majority of neuroendocrine tumors. In this case presentation, it is aimed to demonstrate the role of 68Ga-DOTATATE PET/CT scan beyond the detection of neuroendocrine tumors. A 59-year-old Iranian male patient with clear cell renal cell carcinoma who underwent nephrectomy 4 years ago has been referred for evaluation of a diagnosed painful abdominal mass by CT. 68Ga-DOTATATE PET/CT scan showed a large, lobulated border 68Ga-DOTATATE avid retroperitoneal tumoral mass in the region of pancreatic head and uncinate process, with fat plane obliteration with duodenum and inferior vena cava. Conspicuous physiological uptake has been reported in the pancreatic head in 16 to 70% of 68Ga-DOTATATE. Pathological results and immunohistochemistry evaluations confirmed the renal cell carcinoma based on metastases; so, the suspicious diagnosis of neuroendocrine tumor was ruled out. Malignancies, a part of neuroendocrine tumors, may express somatostatin receptors and 68Ga-DOTATATE or other octreotide derivatives based radiopharmaceuticals uptake appears.