title: Resolution of Hyperreninemia, Secondary Hyperaldosteronism, and Hypokalemia With 177Lu-DOTATATE Induction and Maintenance Peptide Receptor Radionuclide Therapy in a Patient With Pancreatic Neuroendocrine Tumor.
abstract: A 54-year-old woman presented with a history of nausea, vomiting, diarrhea, and recurrent episodes of severe hypokalemia requiring hospitalization. Imaging revealed a pancreatic mass with liver metastases, histologically confirmed to be a neuroendocrine tumor. Elevated active renin and aldosterone levels were identified, and the patient was treated with 4 induction cycles of Lu-DOTATATE, which resolved the diarrhea, nausea, and hypokalemia, and normalized the renin and aldosterone levels. After 3 additional maintenance Lu-DOTATATE treatments, the pancreatic tumor had decreased in size, was deemed operable, and was resected. She remains on maintenance Lu-DOTATATE therapy with progression-free survival of 45 months thus far.
authors.affiliation: From the Department of Diagnostic Imaging, Cross Cancer Institute, Edmonton, Alberta, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Makis
authors.forename: Karey
authors.initials: K
authors.lastname: McCann
authors.forename: Terence A
authors.initials: TA
authors.lastname: Riauka
authors.forename: Alexander J B
authors.initials: AJ
authors.lastname: McEwan
mesh_terms: D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000532:radiotherapy*; D007008:Hypokalemia / Q000532:radiotherapy*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use*
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C447941:lutetium Lu 177 dotatate; D015282:Octreotide