Pulmonary large cell neuroendocrine carcinoma (LCNEC) with confirmed liver metastases negative on 18F-FDG and 68Ga-DOTATATE PET

Gaia Ninatti; Heying Duan; Valentina Ferri; Brock A Martin; Carina Mari Aparici

doi:10.1016/j.radcr.2020.10.023

Pulmonary large cell neuroendocrine carcinoma (LCNEC) with confirmed liver metastases negative on ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET

Radiol Case Rep. 2020 Oct 21;15(12):2698-2700. doi: 10.1016/j.radcr.2020.10.023. eCollection 2020 Dec.

Authors

Gaia Ninatti¹, Heying Duan², Valentina Ferri², Brock A Martin³, Carina Mari Aparici²

Affiliations

¹ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
² Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305-5281, USA.
³ Department of Pathology, Stanford University, Stanford, CA, USA.

Abstract

Lung neuroendocrine neoplasms (NENs) encompass the low-, intermediate-, and high-grade entities. Differentiated NENs overexpress somatostatin receptors, which are targeted by ⁶⁸Ga-DOTA-conjugated peptides in molecular imaging with positron emission tomography. Less differentiated NENs may have lost their expression of somatostatin receptors and thus show lower uptake of ⁶⁸Ga-DOTA-peptides; however, these tumors express GLUT-1 and can be imaged with (18)F-fluordeoxyglucose (FDG). We report the case of a 72-year-old patient with a poorly differentiated, high grade lung NEN, which was ¹⁸F-FDG-positive at initial diagnosis. After treatment and remission, the patient had histologically confirmed relapse in the liver. Interestingly, these hepatic metastases did not demonstrated radiopharmaceutical uptake at neither ¹⁸F-FDG nor ⁶⁸Ga-DOTATATE positron emission tomography/computed tomography.

Keywords: 18F-FDG; 68Ga-DOTATATE; Large cell neuroendocrine carcinoma; Lung neuroendocrine neoplasms; PET/CT; Somatostatin receptors.

Publication types

Case Reports