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Resolution of Hyperreninemia, Secondary Hyperaldosteronism, and Hypokalemia With 177Lu-DOTATATE Induction and Maintenance Peptide Receptor Radionuclide Therapy in a Patient With Pancreatic Neuroendocrine Tumor

Makis, William, MD; McCann, Karey, BScN; Riauka, Terence A., PhD; McEwan, Alexander J.B., MD

doi: 10.1097/RLU.0000000000000962
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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: makisw79@yahoo.com.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.