68Ga-DOTATOC PET/CT in Pancreatic Metastasis From Clear Cell Renal Cell Carcinoma

We present a rare case of a 74-year-old woman who underwent Ga-68-DOTATOC PET/CT imaging for a suspected neuroendocrine tumor (NET) in the pancreatic head. PET/CT showed a solitary high somatostatis receptor (SSTR)-expressing lesion in the pancreatic head. Fine-needle aspiration of this lesion revealed a metastasis from a clear cell renal cell carcinoma (ccRCC). The patient had undergone nephrectomy 16 years prior due to ccRCC of the right kidney. Our case demonstrates that metastases originating from RCC can have high SSTR expression and therefore might mimic well-differentiated neuroendocrine tumors in Ga-68-DOTATOC PET/CT.

Automated summary

We report a unique case of a 74-year-old woman with a suspected neuroendocrine tumor (NET) in the pancreatic head, in which Ga-68-DOTATOC PET/CT imaging revealed a solitary SSTR-expressing lesion. Fine-needle aspiration confirmed that the lesion was a metastasis from a previous clear cell renal cell carcinoma (ccRCC). This case highlights the importance of recognizing that RCC metastases can mimic well-differentiated neuroendocrine tumors in Ga-68-DOTATOC PET/CT.