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Elevated 68Ga-DOTATATE Activity in Fibrous Cortical Defect
Zhe Wen, Lin Zhang, Vandana Batra1
1Department of Radiology, Xiamen Children's Hospital, Xiamen Branch Hospital, Children's Hospital of Fudan University, Xiamen, Fujian, China.
Clinical Nuclear Medicine
|March 10, 2020
Summary
A rare case of cholangiocarcinoma in an adolescent showed unexpected findings on PET/CT scans. Both FDG and Ga-DOTATATE PET/CT revealed abnormal activity in a fibrous cortical defect, a finding not typically associated with this cancer.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Cholangiocarcinoma staging typically involves fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT).
- Neuroendocrine differentiation in cholangiocarcinoma can influence imaging characteristics.
- Fibrous cortical defects are common benign bone lesions.
Observation:
- A 15-year-old female with cholangiocarcinoma presented with mild tumor FDG uptake but significant uptake in a right femoral fibrous cortical defect.
- Pathological examination of the cholangiocarcinoma revealed neuroendocrine differentiation.
- Subsequent Gallium-68 somatostatin receptor positron emission tomography/computed tomography (Ga-DOTATATE PET/CT) also showed increased activity in the same femoral lesion.
Findings:
- The fibrous cortical defect demonstrated unexpected hypermetabolism on both FDG PET/CT and Ga-DOTATATE PET/CT.
- This finding suggests a potential biological activity or specific receptor expression within the fibrous cortical defect.
- The neuroendocrine differentiation of the cholangiocarcinoma may be relevant to the observed imaging findings.
Implications:
- This case highlights the importance of considering unusual patterns in PET/CT imaging, especially in pediatric oncology.
- Further investigation may be warranted to understand the nature of hypermetabolism in fibrous cortical defects.
- The findings could influence the interpretation of incidental findings on somatostatin receptor imaging.
