Solitary Humeral Metastasis in the Absence of Detectable Primary Neuroblastoma on Triple-tracer Imaging With 18F-FDG, 123I-MIBG, and 68Ga-DOTATATE.

Li, Siqi; Lv, Cinian; Xie, Peng; Wang, Wei; Yang, Jigang · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 6-year-old boy presented with a 2-month history of fever of unknown origin. 18F-FDG PET/CT was performed to identify the potential source, revealing a solitary focus of abnormal radiotracer uptake in the left humerus. Bone marrow biopsy confirmed metastatic neuroblastoma. Subsequent 123I-MIBG SPECT/CT and 68Ga-DOTATATE PET/CT scans failed to detect a primary tumor site. This case illustrates that solitary humeral metastasis can occur in the absence of an identifiable primary neuroblastoma, even after comprehensive imaging with 3 different radiotracers: 18F-FDG, 123I-MIBG, and 68Ga-DOTATATE.

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