A 77-year-old woman with history of breast cancer presented with 2 unclear dural contrast-enhancing lesions on MRI; differential diagnoses were breast cancer metastases and meningiomas. On 68Ga-DOTATOC PET/CT, the temporal lesion showed high uptake and was classified as meningioma, whereas the lesion at the falx showed barely any 68Ga-DOTATOC uptake uncharacteristic for meningioma and suggestive for a brain metastasis. After resection, histological specimens from the temporal lesion showed meningioma tissue with distinct SSTR2A expression, whereas the falx lesion revealed a breast cancer metastasis without significant SSTR2A expression. Therefore, 68Ga-DOTATOC PET represents a powerful imaging modality for the evaluation of unclear dural lesions.
From the *Department of Nuclear Medicine, University Hospital, LMU Munich;
†German Cancer Consortium (DKTK), Partner Site Munich, Munich, and German Cancer Research Center (DKFZ), Heidelberg;
Departments of ‡Neuropathology,
∥Radiation Oncology, and
¶Neurosurgery, University Hospital, LMU Munich, Munich, Germany.
Received for publication December 5, 2018; revision accepted January 18, 2019.
Conflicts of interest and sources of funding: none declared.
Author's contributions: M.U. contributed to the drafting of the manuscript, PET/CT reading, and conceiving of the design. V.R. contributed to the neuropathological evaluation, increase in the intellectual content, and revision of the manuscript. H.I., V.F., and C.C.C. contributed to the PET/CT reading, increase in the intellectual content, and revision of the manuscript. C.C.C. contributed to the MRI reading. M.N., P.B., and J.C.T. contributed to the clinical management, increase in the intellectual content, and revision of the manuscript. N.L.A. contributed to drafting of the manuscript and conceiving of the design.
Correspondence to: Marcus Unterrainer, MD, MSc, Department of Nuclear Medicine, University Hospital, LMU Munich, LMU Marchioninistraße 15, 81377 Munich, Germany. E-mail: email@example.com.