gallium-ga-68-dotatate and Pancreatic-Diseases

Intrapancreatic accessory spleen (IPAS) is an uncommon finding of pancreatic mass. Differential diagnosis with pancreatic tumor, especially with non-functional neuroendocrine tumor (NF-NET), may be very hard and sometimes it entails unnecessary surgery. A combination of CT scan, MRI, and nuclear medicine can confirm the diagnosis of IPAS. 68-Ga-Dotatoc PET/CT is the gold standard in NET diagnosis and it can allow to distinguish between IPAS and NET.. A 69-year-old man was admitted to our hospital for an incidental nodule in the tail of the pancreas with focal uptake of 68-Ga-dotatate at PET/CT. NET was suspected and open distal splenopancreatectomy was performed. Pathologic examination revealed an IPAS.. This is the second IPAS case in which a positive 68Ga-Dotatoc uptake led to a false diagnosis of pancreatic NET. Here is a proposal of a literature review.

Topics: Aged; Diagnosis, Differential; False Positive Reactions; Humans; Male; Neuroendocrine Tumors; Organometallic Compounds; Pancreatectomy; Pancreatic Diseases; Positron Emission Tomography Computed Tomography; Prognosis; Splenectomy; Splenic Diseases

Intrapancreatic accessory spleens are relatively uncommon and can be difficult to distinguish from neuroendocrine tumours on CT, MRI and somatostatin receptor scintigraphy. We present the case of a 26-year-old woman with an incidentally diagnosed pancreatic lesion confirmed to be an intrapancreatic accessory spleen on Tc-99m heat-denatured red blood cell single photon emission computed tomography/CT.

Topics: Adult; Choristoma; Contrast Media; Erythrocytes; Female; Humans; Incidental Findings; Organometallic Compounds; Pancreatic Diseases; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Single Photon Emission Computed Tomography Computed Tomography; Spleen; Tomography, Emission-Computed

Neuroendocrine tumors (NETs) are rare tumors, but the incidence is increasing with new diagnostics. A 37-year-old man was admitted to our hospital for an incidental 17-mm nodule in the tail of the pancreas. PET/CT shows indeterminate mass in the pancreatic tail with enhanced uptake of 68-Ga-dotatate. NET was suspected and laparoscopic distal pancreatectomy was performed. Pathologic examination revealed an accessory spleen with a heterotopic location. To the best of our knowledge, this is the first intrapancreatic accessory spleen (IPAS) case in which the positive 68-Ga-dotatate uptake reported in the literature. Our case showed that IPAS is one of the reasons of false positive involvement of 68-Ga-dotatate PET/CT. When PET/CT shows an indeterminate mass in the pancreatic tail with enhanced uptake of 68-Ga-dotatate, surgeons should keep IPAS in their mind for differential diagnosis to avoid false treatment.

Topics: Adult; Choristoma; Diagnosis, Differential; Humans; Male; Neuroendocrine Tumors; Organometallic Compounds; Pancreatectomy; Pancreatic Diseases; Pancreatic Neoplasms; Positron Emission Tomography Computed Tomography; Spleen; Ultrasonography