Clinical nuclear medicine vol:34 issue:1 pages:27-28
A 61-year-old man presented with the sudden onset of blurry vision. of the right eve. Conventional ophthalmologic examination and magnetic resonance index were suspicious for a choroidal melanoma. Fludeoxyglucose positron emission tomography imaging showed no increased uptake. rendering the diagnosis of melanoma most unlikely. Because of the patient had a history of bronchial carcinoid tumor (pT2N0Mx) 3 years ago. further work-up included ophthalmologic echography (A-scan) showing a probable metastatic lesion. Evaluation of the chromogranin blood level and Ga-68 Positron emission tomography-computed tomography DOTATOC-PET/CT revealed high uptake in the ocular lesion and further tumor localization in the mediastinum. liver, and pancreas. The pattern was considered highly suspicious for metastases. and without further anatomopathological analysis. the patient was referred for external beam radiotherapy and additional radiopeptide receptor therapy with Lu-177-DOTATATE. This case illustrates the use of Ga-68 DOTATOC-PET/CT in a difficult clinical problem, where fludeoxyglucose-PET/CT did not provide a final diagnosis.