False Positive of 68Ga-DOTATATE PET-CT in a Paraganglioma

Background: Functional imaging with Ga-68-DOTATATE PET-CT is widely employed to detect both primary and metastatic pheochromocytomas and paragangliomas (PGL), but its results may be occasionally misleading as in the case here reported. Case Presentation: We report here a 75-year-old woman with an interaortocaval PGL that was diagnosed after a hypertensive crisis occurring during the resection of a kidney tumor. Ga-68-DOTATATE PET-CT disclosed pathologic uptake in the abdomen and at the iliac crest. After the resection of the abdominal tumor, with the histological confirmation of PGL, arterial blood pressure and metanephrine levels were normalized. Genetic testing was negative. Thereafter, the bone lesion increased in size and became painful, requiring multiple medications. A selective biopsy disclosed a metastatic lesion arising from the renal tumor. Conclusion: The false-positive result of Ga-68-DOTATATE PET-CT is discussed.

Automated summary

This case study describes a 75-year-old female patient diagnosed with an interaortocaval paraganglioma following the resection of a kidney tumor. Although Ga-68-DOTATATE PET-CT showed pathological uptake in the abdomen and iliac crest, it still resulted in a false-positive outcome.