Abstract
Dual tracer PET/CT examinations (18F-FDG/68Ga-DOTATATE) have become an established practice in management of metastatic Neuroendocrine neoplasms (NENs) and demonstrates the advantages of deciphering the molecular PET characteristics of the tumor in patient management. Judicious elucidation of the findings is important, especially in scenarios of discordance with reported histopathology; this can lead to unsuspected diagnosis such as second primary malignancies (SPMs). Such diagnosis established in early disease course and mostly in an asymptomatic stage, provides patient a lead time for timely appropriate management. This concept is elaborated with a case-example of incidentally detected 18F-FDG avid metachronous adenocarcinoma lung in a patient of metastatic well-differentiated gastric NEN, wherein dual tracer PET/CT assessment had demonstrated FDG avid but non-68Ga-DOTATATE avid lung opacity.
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