F-18-FDG PET/CT and Ga-68-DOTATOC PET/CT in Diffuse Pancreatic Neuroendocrine Tumor

We present 2 cases of pancreatic neuroendocrine tumor with diffuse involvement of the entire pancreas. One case with G2 pancreatic neuroendocrine tumor showed nearly normal pancreatic shape and signal intensity on MRI, normal pancreatic (18)FDG uptake, and diffuse pancreatic Ga-68-DOTATOC uptake. The other case with G3 pancreatic neuroendocrine tumor showed diffusely enlarged pancreas with abnormal MR signal intensity and increased (18)FDG uptake. These 2 cases indicate that neuroendocrine tumor should be included in the differential diagnosis of diffuse pancreatic diseases. Somatostatin receptor imaging may be helpful for the diagnosis of diffuse pancreatic neuroendocrine tumor in equivocal cases.