gallium-ga-68-dotatate and Granuloma

The importance of 68Ga-DOTATATE PET/CT in the evaluation of neuroendocrine tumors is well established. However, false-positive results can occur due to inflammatory pathologies. We report a 47-year-old man who was diagnosed with a neuroendocrine tumor of the stomach. Initial 68Ga-DOTATATE PET/CT showed intense 68Ga-DOTATATE uptake in the petrous apex. Histopathological confirmation could not be obtained, thus the asymptomatic patient was followed with periodic clinical/radiologic examinations for more than 2.5 years. Therefore, this lesion was diagnosed as a cholesterol granuloma of the temporal bone. These results suggested that an initial wait-and-scan approach is a feasible management strategy for similar presentations.

Topics: Cholesterol; Granuloma; Humans; Male; Middle Aged; Neuroendocrine Tumors; Organometallic Compounds; Petrous Bone; Positron Emission Tomography Computed Tomography

Positron imaging with radiolabeled synthetic somatostatin receptor analogs such as Ga DOTATATE (Gallium-68-1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetra acetic acid-DPhe1,Tyr3-octreotate) is used for diagnosis and target volume delineation of intracranial meningiomas. We report a case of a somatostatin receptor-positive extra-axial necrotizing granulomatous inflammation mimicking as meningioma on simultaneous Ga DOTATATE PET/MRI. This case illustrates a Ga DOTATATE-positive granuloma bearing a striking resemblance to meningioma.

Topics: Aged; Diagnosis, Differential; Female; Granuloma; Humans; Inflammation; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Multimodal Imaging; Organometallic Compounds; Positron-Emission Tomography; Radiopharmaceuticals; Receptors, Somatostatin