title: Complete Remission of Metastatic Neuroendocrine Paragastric Carcinoma After "Neoadjuvant" Peptide Receptor Radionuclide Therapy and Surgery.
abstract: A 48-year-old man presenting with upper abdominal pain was diagnosed with neuroendocrine tumor after biopsy of a paragastric mass with multiple liver metastases. (68)Ga-DOTATATE PET/CT showed intense uptake in the paragastric tumor and in multiple liver metastases not allowing primary surgery. Two cycles with cumulative 14.6 GBq (177)Lu-DOTATATE were given resulting in a considerable improvement. Subsequent surgery resulted in a complete remission as demonstrated by (68)Ga-DOTATATE PET/CT. Usually, peptide receptor radionuclide (PRRT) therapy is considered a palliative treatment. Few patients demonstrate a very favorable response allowing resection of the primary tumor after downstaging metastatic disease burden.
authors.affiliation: From the *Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany; †Gemeinschaftspraxis für Onkologie und Hämatologie, Cologne, Germany; ‡Institute of Pathology, University Hospital of Cologne, Cologne, Germany; and §Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany.
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Schmidt
authors.forename: Klara
authors.initials: K
authors.lastname: Uhrhan
authors.forename: Thomas
authors.initials: T
authors.lastname: Fischer
authors.forename: Stephan
authors.initials: S
authors.lastname: Schmitz
authors.forename: Birgid
authors.initials: B
authors.lastname: Markiefka
authors.forename: Alexander
authors.initials: A
authors.lastname: Drzezga
authors.forename: Dirk
authors.initials: D
authors.lastname: Stippel
mesh_terms: D018278:Carcinoma, Neuroendocrine / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012074:Remission Induction
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C447941:lutetium Lu 177 dotatate; D015282:Octreotide