Complete Remission of Metastatic Neuroendocrine Paragastric Carcinoma After "Neoadjuvant" Peptide Receptor Radionuclide Therapy and Surgery.

Abstract

A 48-year-old man presenting with upper abdominal pain was diagnosed with neuroendocrine tumor after biopsy of a paragastric mass with multiple liver metastases. (68)Ga-DOTATATE PET/CT showed intense uptake in the paragastric tumor and in multiple liver metastases not allowing primary surgery. Two cycles with cumulative 14.6 GBq (177)Lu-DOTATATE were given resulting in a considerable improvement. Subsequent surgery resulted in a complete remission as demonstrated by (68)Ga-DOTATATE PET/CT. Usually, peptide receptor radionuclide (PRRT) therapy is considered a palliative treatment. Few patients demonstrate a very favorable response allowing resection of the primary tumor after downstaging metastatic disease burden.

• Authors: Matthias C Schmidt, Klara Uhrhan, Thomas Fischer, Stephan Schmitz, Birgid Markiefka, Alexander Drzezga, Dirk Stippel
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 40 Issue 8 Pg. 667-9 (Aug 2015) ISSN: 1536-0229 [Electronic] United States
• PMID: 26053706 (Publication Type: Case Reports, Journal Article)

Chemical References

• Organometallic Compounds
• Radiopharmaceuticals
• lutetium Lu 177 dotatate
• Octreotide

Topics

• Carcinoma, Neuroendocrine (pathology, radiotherapy, surgery)
• Humans
• Liver Neoplasms (radiotherapy, secondary, surgery)
• Male
• Middle Aged
• Neuroendocrine Tumors (pathology, radiotherapy, surgery)
• Octreotide (analogs & derivatives, therapeutic use)
• Organometallic Compounds (therapeutic use)
• Radiopharmaceuticals (therapeutic use)
• Remission Induction