99m Tc-FAPI-46 Scintigraphy and Radioligand Therapy With 177 Lu-FAPI-2286 in Locally Advanced Epithelioid Sarcoma.

Raeisi, Nasrin; Saber Tanha, Amin; Aryana, Kamran; Shahid Sales, Soodabeh; Barashki, Somaye · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Epithelioid sarcoma (ES) is an ultra-rare and aggressive soft tissue malignancy, predominantly affecting the extremities. Scalp involvement in ES is exceedingly uncommon. This case report describes a 25-year-old man diagnosed with a scalp mass confirmed to be ES. Despite undergoing surgical resection and adjuvant chemoradiation, the tumor recurred, causing significant pain and erosion of adjacent bony structures. A multidisciplinary team recommended 99m Tc-FAPI-46 scintigraphy, which demonstrated high uptake in the tumor masses. The patient was subsequently treated with 177 Lu-FAPI-2286 in 4 cycles. Initial cycles showed promising treatment responses; however, disease progression was observed in the final cycle.

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