Petrous Apex Cholesterol Granuloma Showing 68Ga-DOTATATE Uptake

Abstract

The importance of 68Ga-DOTATATE PET/CT in the evaluation of neuroendocrine tumors is well established. However, false-positive results can occur due to inflammatory pathologies. We report a 47-year-old man who was diagnosed with a neuroendocrine tumor of the stomach. Initial 68Ga-DOTATATE PET/CT showed intense 68Ga-DOTATATE uptake in the petrous apex. Histopathological confirmation could not be obtained, thus the asymptomatic patient was followed with periodic clinical/radiologic examinations for more than 2.5 years. Therefore, this lesion was diagnosed as a cholesterol granuloma of the temporal bone. These results suggested that an initial wait-and-scan approach is a feasible management strategy for similar presentations.

68Ga-DOTATATE and 68Ga-PSMA Uptake in Granulomatous Prostatitis

“…[2][3][4][5] In addition, SSTR2 is frequently expressed in inflammatory cells, especially in granuloma cells, leading to the high uptake of 68 Ga-DOTATATE by granulomatous lesions. [6][7][8] Furthermore, there is an overlap in the presentation of prostate cancer and granulomatous prostatitis on MRI, 9 and attention should be paid to the differential diagnosis. The findings of this case suggest that, although the prostate lesion has a high uptake of 18 F-FDG, 68 Ga-DOTATATE, and 68 Ga-PSMA, care should be taken to differentiate it from inflammatory lesions in diagnosing prostate cancer.…”

“…1 68 Ga-PSMA is also highly taken up by inflammatory lesions, such as esophagitis, mediastinal sarcoidosis, anal fistula, and sigmoid diverticulitis [2][3][4][5]. In addition, SSTR2 is frequently expressed in inflammatory cells, especially in granuloma cells, leading to the high uptake of 68 Ga-DOTATATE by granulomatous lesions [6][7][8]. Furthermore, there is an overlap in the presentation of prostate cancer and granulomatous prostatitis on MRI,9 and attention should be paid to the differential diagnosis.…”