A 71-year-old man with history of prostate cancer is evaluated for rising prostate-specific antigen. The patient also has a history of rectal well-differentiated neuroendocrine tumor. On 18F-fluciclovine PET/CT, 2 retroperitoneal lymph nodes exhibited intense fluciclovine avidity, whereas one enlarged perirectal lymph node only showed background uptake. On further 68Ga-DOTATATE PET/CT, the perirectal lymph node revealed intense DOTATATE avidity, whereas the 2 retroperitoneal lymph nodes only with similar to background DOTATATE avidity. Biopsy of the perirectal lymph node confirmed metastasis from neuroendocrine tumor. The distinct imaging characteristics of metastases from different primary malignancies correlated with their underlying different pathology.
From the *Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston McGovern Medical School;
†Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX; and
‡Department of Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Received for publication August 26, 2018; revision accepted September 25, 2018.
Conflicts of interest and sources of funding: none declared.
Correspondence to: Yang Lu, MD, PhD, Division of Diagnostic Imaging, Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler Unit Number 1483, Houston, TX 77030. E-mail: email@example.com.