lutetium-lu-177-dotatate and Hemangioendothelioma

Gallbladder visualization represents a rare incidental finding when using somatostatin receptor-targeted SPECT radiopharmaceuticals such as In-octreotide. We present the case of a 30-year-old man with pseudomyogenic hemangioendothelioma who underwent Ga-DOTATATE PET/CT for restaging of metastatic disease and subsequent treatment with peptide receptor radionuclide therapy with Lu-DOTATATE. Posttherapeutic SPECT/CT, but not pretherapeutic or posttherapeutic PET/CT, showed gallbladder visualization, evidencing Lu-DOTATATE excretion into the bile. This case highlights that biliary Lu-DOTATATE excretion may represent a rare mimicker of hepatic metastases and emphasizes the role SPECT/CT for precise anatomical correlation to avoid misinterpretation.

Topics: Adult; Diagnosis, Differential; Gallbladder; Hemangioendothelioma; Humans; Incidental Findings; Liver Neoplasms; Male; Octreotide; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Receptors, Peptide; Single Photon Emission Computed Tomography Computed Tomography