Hepatocellular Carcinoma Mimicking Neuroendocrine Tumor Metastasis on 68Ga-DOTATATE PET/CT

68Ga-DOTATATE is a radiolabeled somatostatin analog used for the detection and characterization of somatostatin receptor (SSR)–overexpressing tumors, particularly well-differentiated neuroendocrine tumors. We present a case of a 65-year-old man with well-differentiated pancreatic neuroendocrine tumor post–Whipple surgery and a new liver lesion on CT. 68Ga-DOTATATE PET/CT was performed for SSR characterization and restaging, which demonstrated the lesion to be intensely SSR positive and interpreted as a neuroendocrine metastasis. However, subsequent pathology proved the lesion to be a hepatocellular carcinoma. This case adds hepatocellular carcinoma as a potentially DOTATATE-avid malignancy to be considered in the differential diagnoses of SSR-positive liver lesions. Received for publication November 19, 2018; revision accepted December 9, 2018. Conflicts of interest and sources of funding: L.B. is a consultant for Ipsen and AAA. G.A.U. is a consultant for Sanofi. Correspondence to: Gary A. Ulaner, MD, PhD, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065. E-mail: ulanerg@mskcc.org. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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