Interesting ImagesTwelve-Year Survival of a Patient With Lymph Node, Pulmonary, Bone, Cardiac and Intraspinal Metastases of a Rectal Neuroendocrine Neoplasm Treated With Peptide Receptor Radionuclide Therapy—The Value of Salvage Peptide Receptor Radionuclide TherapyZhang, Jingjing MD, PhD; Kulkarni, Harshad R. MD; Singh, Aviral MD, MSc; Baum, Richard P. MD, PhDAuthor Information From the THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany. Received for publication August 7, 2019; revision accepted October 19, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Jingjing Zhang, MD, PhD, THERANOSTICS Center for Molecular, Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany. E-mail: firstname.lastname@example.org. Online date: December 24, 2019 Clinical Nuclear Medicine: April 2020 - Volume 45 - Issue 4 - p e198-e200 doi: 10.1097/RLU.0000000000002905 Buy Metrics Abstract We report here the 12-year survival after the first peptide receptor radionuclide therapy (PRRT) of a patient with metastatic rectal neuroendocrine neoplasms, who received 7 cycles of PRRT with 177Lu/90Y-DOTATATE/DOTATOC in 4 treatment phases. The patient demonstrated excellent response to each cycle of treatment, without any adverse effect even after repeated PRRT cycles. Most recently, immunohistochemistry revealed a G3 neuroendocrine neoplasm and intraspinal metastasis were successfully resected by neurosurgical intervention. This case nicely demonstrates that several “salvage” PRRTs can be given over many years leading to repetitive benefit for the patient and saving patients of possible toxicity of alternative treatments. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.