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Whole-Body Staging of Metastatic Atypical Meningioma Using 68Ga-DOTATATE PET/CT

Unterrainer, Marcus, MD, MSc*†; Ilhan, Harun, MD*; Vettermann, Franziska, MD*; Cyran, Clemens C., MD; Tonn, Joerg C., MD†§; Niyazi, Maximilian, MD†∥; Bartenstein, Peter, MD*†; Albert, Nathalie L., MD*†

doi: 10.1097/RLU.0000000000002422
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A 43-year-old woman with suspected recurrence of atypical meningioma World Health Organization grade II presented extensive intracranial lesions with high 68Ga-DOTATATE uptake. Moreover, numerous 68Ga-DOTATATE–positive bone, lung, and liver lesions were seen. For final diagnosis, biopsies taken from a lung lesion revealed distant metastases of the atypical meningioma. This case underlines the high diagnostic power of 68Ga-DOTATATE PET/CT for the staging of meningioma even beyond cerebral or spinal lesions; in case of distant lesions in patients with known meningioma, differential diagnosis should also contain metastases despite their rare occurrence. Moreover, this case emphasizes radioligand therapy especially in metastatic meningioma.

From the *Department of Nuclear Medicine, University Hospital, LMU Munich, Munich;

German Cancer Consortium (DKTK), Partner Site Munich, and German Cancer Research Center (DKFZ), Heidelberg; and Departments of

Radiology,

§Neurosurgery, and

Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.

Received for publication October 8, 2018; revision accepted October 31, 2018.

Conflicts of interest and sources of funding: none declared.

Author Contributions: Drafted the manuscript, PET/CT reading, and conceived the design (M.U.); PET/CT reading, increased the intellectual content, and revised the manuscript (H.I., F.V., and C.C.C.); clinical management, increased the intellectual content and revised the manuscript (J.C.T., M.N., and P.B.); drafted the manuscript and conceived the design (N.L.A.).

Correspondence to: Marcus Unterrainer, MD, MSc, Department of Nuclear Medicine, LMU, Marchioninistr. 15, 81377 Munich, Germany. E-mail: marcus.unterrainer@med.uni-muenchen.de.

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