Pancreatic serous cystoadenoma (CSA) showing increased tracer uptake at 68-GaDOTA-peptide Positron Emission Tomography (
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CASE REPORT
Pancreatic serous cystoadenoma (CSA) showing increased tracer uptake at 68‑GaDOTA‑peptide Positron Emission Tomography (68Ga‑DOTA‑peptide PET‑CT): a case report Gennaro Nappo1*, Niccola Funel2, Simone Giudici1, Paola Spaggiari3, Giovanni Capretti1, Silvia Carrara4, Giovanna Pepe5 and Alessandro Zerbi1,6
Abstract Background: Serous cysto-adenoma (SCA) is a rare benign neoplasm of the pancreas. SCA can mimic other pancreatic lesions, such as neuroendocrine tumours. 68Gallium-DOTA-peptide Positron Emission Tomography (PET) is able to image in vivo the over-expression of the somatostatin receptors, playing an important role for the identification of neuroendocrine neoplasms. Case presentation: We reported a case of 63-year-old man, with a solid lesion of 7 cm of diameter of the body– tail of the pancreas. Two fine-needle-aspirations (FNA) were inconclusive. A 68Ga-DOTA-peptide PET-CT revealed a pathological uptake of the pancreatic lesion. The diagnosis of a pancreatic neuroendocrine neoplasm was established and a laparoscopic distal splenopancreatectomy and cholecystectomy was performed. Final histopathological report revealed the presence of a micro-cystic SCA. Conclusions: The current case firstly reports a pancreatic SCA showing increased radiopharmaceutical uptake at 68Ga-DOTA-peptide PET-CT images. This unexpected finding should be taken into account during the diagnostic algorithm of a pancreatic lesion, in order to minimize the risk of misdiagnosis and overtreatment of SCA. Keywords: Pancreatic serous cystoadenoma, Ga68-DOTA-peptide PET-CT, Pancreatic cystic lesions, Pancreatic neuroendocrine neoplasms, Case report Background Serous cysto-adenoma (SCA) is a rare benign neoplasm of the pancreas [1]. SCA can mimic other pancreatic lesions: about 10% of pancreatic neuroendocrine tumours (pNET) appears cystic on imaging and can be misdiagnosed with SCA [2]. 68Gallium-DOTA-peptide *Correspondence: [email protected] 1 Pancreatic Surgery Unit, Humanitas Clinical and Research Center-IRCCS Rozzano, Via Alessandro Manzoni, 56, 20089 Rozzano, Milan, Italy Full list of author information is available at the end of the article
Positron Emission Tomography (PET) is able to image in vivo the over-expression of the somatostatin receptors, playing an important role for the identification of neuroendocrine neoplasms [3]. The following case-report firstly describes a pancreatic SCA showing uptake to 68-Gallium-DOTA-peptide. This case confirms the diagnostic challenge offered by pancreatic cystic neoplasms and encourages future investigations on the usefulness of 68Ga-DOTA-peptide in discriminating pancreatic SCA from pancreatic NET.
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