A Masquerading Return: When Metastatic Renal Cell Carcinoma Recurs After 20 Years to Mimic a Pancreatic Neuroendocrine Tumor on Somatostatin Receptor PET Imaging.

Sharma, Abhishek; Thakur, Purnima; Kumar, Vipan; Singh, Harpreet; Gupta, Manish · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 71-year-old man presented with weight loss and abdominal bloating for 3 months. He was a known case of clear cell renal cell carcinoma (ccRCC) in remission. Investigations discovered an enhancing lesion in the pancreatic head and neck region, which on 68 Ga-DOTATATE PET imaging showed intense tracer-avidity along with tracer-avid lung nodules and a muscular soft tissue lesion mimicking a metastatic pancreatic neuroendocrine tumor. However, the histopathology of the pancreatic mass revealed metastatic ccRCC. This case highlights that RCC can cause extremely late recurrences and rarely mimics neuroendocrine tumors (NETs) due to SSTR expression.

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