The Sunburst Sign in the Mesentery: Unveiling the Diagnosis With ⁶⁸Ga DOTATATE PET/CT.

Şahin, Ömer F; Şahin, Dilruba; Tosunoğlu, Zehranur · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Contrast-enhanced abdominal CT of a 57-year-old man presenting with abdominal pain and diarrhea revealed a spiculated, calcified mesenteric mass, initially suggesting a desmoid tumor (DT). The lesion's ametabolic nature on 18 F-FDG PET/CT supported this suspicion. However, ⁶⁸Ga DOTATATE PET/CT demonstrated intense uptake in both the mesenteric mass, which exhibited a "sunburst" calcification pattern, and the primary ileal focus. Histopathology confirmed an ileal neuroendocrine tumor (NET) with mesenteric lymph node metastasis. This case highlights the critical role of ⁶⁸Ga DOTATATE PET/CT in the differential diagnosis, primary site detection, and accurate staging of FDG-negative mesenteric masses associated with a desmoplastic reaction.

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