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DOI: 10.1055/s-0045-1813681
Incidental 68Ga -DOTATATE Uptake in Metastatic Clear Cell Renal Cell Carcinoma: A Case Report
Authors
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.
Keywords
gallium-68 - neuroendocrine tumors - diagnostic - somatostatin receptor - renal cell carcinoma - DOTATATEAuthors' Contributions
All authors contributed equally to this study and approved the final article.
Ethical Approval and Consent to Participate
Ethical approval and consent to participate are not required for this case report, because the research does not require any tactical actions or interventions on patients; it is an observational study.
Publication History
Article published online:
23 November 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Bengtsen MB, Farkas DK, Sørensen HT, Nørgaard M. Renal cell carcinoma and risk of second primary cancer: a Danish nationwide cohort study. Cancer Med 2024; 13 (11) e7237
- 2 Hsieh JJ, Purdue MP, Signoretti S. et al. Renal cell carcinoma. Nat Rev Dis Primers 2017; 3 (01) 17009
- 3 Rathmell WK, Rumble RB, Van Veldhuizen PJ. et al. Management of metastatic clear cell renal cell carcinoma: ASCO guideline. J Clin Oncol 2022; 40 (25) 2957-2995
- 4 Höög A, Kjellman M, Mattsson P, Juhlin CC, Shabo I. Somatostatin receptor expression in renal cell carcinoma—a new front in the diagnostics and treatment of renal cell carcinoma. Clin Genitourin Cancer 2018; 16 (03) e517-e520
- 5 Filizoglu N, Ozguven S. Solitary contralateral adrenal metastasis of renal cell carcinoma: 68Ga-DOTATATE PET/CT findings. Clin Nucl Med 2022; 47 (01) e41-e42
- 6 Watanabe N, Nakanishi Y, Kinukawa N. et al. Expressions of somatostatin receptor subtypes (SSTR-1, 2, 3, 4 and 5) in neuroblastic tumors; special reference to clinicopathological correlations with international neuroblastoma pathology classification and outcomes. Acta Histochem Cytochem 2014; 47 (05) 219-229
- 7 Hope TA, Bergsland EK, Bozkurt MF. et al. Appropriate use criteria for somatostatin receptor PET imaging in neuroendocrine tumors. J Nucl Med 2018; 59 (01) 66-74
- 8 Patel M, Jha A, Antic T. et al. 68Ga-DOTATATE avid metastatic vertebral renal cell carcinoma in the setting of von Hippel-Lindau syndrome. Nucl Med Mol Imaging 2022; 56 (05) 259-262
- 9 Vamadevan S, Le K, Shen L, Stevanovic A, Loh H, Mansberg R. 68Ga-DOTATATE uptake in a soft tissue metastasis from clear cell renal cell cancer. Clin Nucl Med 2018; 43 (01) 44-45
- 10 Ramos LR, Królicki L, Pawlak D, Zerizer I, Mikołajczak R. False positive 68Ga-DOTA-NOC: role for endoscopic ultrasound assessment. Revista Portuguesa de Endocrinologia. Diabetes Metab 2016; 11 (01) 57-59
- 11 Kunikowska J, Marques PP, Silva A, Pereira BD. Semiquantitative analysis and characterization of physiological biodistribution of (68)Ga-DOTA-TATE PET/CT. Clin Nucl Med 2012; 37 (11) 1052-1057
- 12 Krausz Y, Rubinstein R, Appelbaum L. et al. Ga-68 DOTA-NOC uptake in the pancreas: pathological and physiological patterns. Clin Nucl Med 2012; 37 (01) 57-62
- 13 Brabander T, Teunissen J, Kwekkeboom D. Physiological uptake in the pancreatic head on somatostatin receptor scintigraphy using [111In-DTPA] octreotide: incidence and mechanism. Clin Nucl Med 2017; 42 (01) 15-19
- 14 Kroiss A, Putzer D, Decristoforo C. et al. 68Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med Mol Imaging 2013; 40 (04) 514-523
- 15 Ait Boudaoud A, Verges B, Petit JM, Tatulashvili S, Cochet A, Humbert O. Uptake in the pancreatic uncinate process on the 111In-octreotide scintigraphy: how to distinguish physiological from pathological uptake?. Nucl Med Commun 2017; 38 (09) 737-743
- 16 Soydal C, Nak D, Araz M, Demirkazik A, Kucuk NO. 68Ga-DOTATATE uptake in pancreatic metastasis of renal cell carcinoma mimicking pancreatic neuroendocrine tumor. Clin Nucl Med 2019; 44 (10) 795-796
- 17 Lakhotia R, Jhawar S, Malayeri AA, Millo C, Del Rivero J, Ahlman MA. Incidental 68Ga-DOTATATE uptake in the pancreatic head: a case report and a unique opportunity to improve clinical care. Medicine (Baltimore) 2020; 99 (22) e20197

