177 Lu-DOTATATE PRRT for Multiple Unusual Metastatic Sites in Neuroendocrine Tumor.

Thyroid gland and orbit are rare sites of metastases in neuroendocrine tumors. We present an extremely rare case of rectal neuroendocrine tumor with metastases to thyroid gland and intra-orbital regions that demonstrated significant reduction in size and uptake of the lesions on somatostatin receptor based 68 Ga-DOTATATE PET/CT, following 177 Lu-DOTATATE peptide receptor radionuclide therapy. The case illustrates the efficacy of 177 Lu-DOTATATE peptide receptor radionuclide therapy for tumor cytoreduction, which can be considered as a promising treatment modality for somatostatin receptor expressing and tracer-avid metastatic lesions at multiple rare locations.