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 177Lu-DOTATATE, which resolved the diarrhea, nausea, and hypokalemia, and normalized the renin and aldosterone levels. After 3 additional maintenance 177Lu-DOTATATE treatments, the pancreatic tumor had decreased in size, was deemed operable, and was resected. She remains on maintenance 177Lu-DOTATATE therapy with progression-free survival of 45 months thus far.
From the Department of Diagnostic Imaging, Cross Cancer Institute, Edmonton, Alberta, Canada.
Received for publication January 8, 2015; revision accepted July 3, 2015.
Conflicts of interest and sources of funding: none declared.
Correspondence to: William Makis, MD, Department of Diagnostic Imaging, Cross Cancer Institute, 11560 University Ave NW, Edmonton, Alberta, T6G 1Z2, Canada. Email: firstname.lastname@example.org.