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Updated: Sep 16, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Risk of bowel ischemia in patients with mesenteric neuroendocrine tumors after treatment with 177Lu-DOTATATE
Eleonora Pelle1, Taymeyah Al-Toubah1, Ghassan El-Haddad2
1Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Background:
Lutetium-177 (177Lu)-DOTATATE is an effective treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors, which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-DOTATATE-treated patients.
Methods:
Clinical records were reviewed of patients with midgut NETs treated with 177Lu-DOTATATE at the Moffitt Cancer Center between April 2018 and December 2022 and at The Ohio State University between December 2017 and October 2020.
Results:
Among the cases reviewed, we identified three patients who developed bowel ischemia/perforation shortly after their initial treatment with 177Lu-DOTATATE. All patients had metastatic small bowel NET with prominent mesenteric mass encasing/obstructing the mesenteric vessels and preexisting symptoms of postprandial abdominal pain.
Conclusion:
Acute bowel ischemia may be a rare complication of PRRT in patients with mesenteric arterial or venous obstruction from mesenteric metastasis.
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