EJNMMI research · 2026
Incidental [68Ga]Ga-DOTATATE uptake in bone metastases of breast carcinoma in a patient with a secondary carcinoid tumor.
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Kemle Jan, Pop Sabin G, Sauter Alexander, Pereira Rafael, Nothhelfer Tilly, Singer Gad, Leo Cornelia, Burger Irene A
Аннотация
BACKGROUND: Lobular breast cancer often shows only low [18F]FDG uptake, limiting the sensitivity to detect metastases. Alternative tracers, targeting tumor activated fibroblasts or estrogen receptors, can offer higher accuracy. Also, Somatostatin Receptor 2 (SSTR2) is significantly expressed in some breast cancers, particularly in estrogen receptor rich tumors. Typical pulmonary carcinoids also have low [18F]FDG accumulation, but approximately 63% of well-differentiated lesions express SSTR2.
CASE PRESENTATION: We report the case of a 66-year-old female patient with lobular breast cancer and a coincidentally discovered typical carcinoid of the lung. On subsequent [68Ga]Ga-DOTATATE PET/CT to stage the carcinoid tumor, two SSTR2 positive focal lesions in the bones were present, without [18F]FDG uptake but with mild sclerosis, atypical for metastasis of carcinoids. Biopsy confirmed osseous breast cancer metastases.
CONCLUSION: SSTR2 expression in normal breast tissue and breast carcinoma has been described previously. However, the case underscores the importance of awareness of atypical presentations of cancer within a multi-tracer approach, whereby receptor profile and morphology must be carefully integrated.
CASE PRESENTATION: We report the case of a 66-year-old female patient with lobular breast cancer and a coincidentally discovered typical carcinoid of the lung. On subsequent [68Ga]Ga-DOTATATE PET/CT to stage the carcinoid tumor, two SSTR2 positive focal lesions in the bones were present, without [18F]FDG uptake but with mild sclerosis, atypical for metastasis of carcinoids. Biopsy confirmed osseous breast cancer metastases.
CONCLUSION: SSTR2 expression in normal breast tissue and breast carcinoma has been described previously. However, the case underscores the importance of awareness of atypical presentations of cancer within a multi-tracer approach, whereby receptor profile and morphology must be carefully integrated.