Abstract
In-111 DTPA-D-Phe1-octreotide (In-111 pentetreotide) is a widely used radiotracer for somatostatin receptor (SSTR) in- vestigations in neuroendocrine (NE) pathology. Cellular SSTR den- sity is directly related to the degree of NE cellular differentiation. Poorly differentiated cell lines show a surface reduction of SSTRs, which may lead to misinterpreting the In-111 pentetreotide scintig- raphy results as negative. A case of anorectal small-cell undifferen- tiated neuroendocrine carcinoma is reported. This pathologic finding is rare, highly aggressive, and associated with a dramatic prognosis. The patient was investigated with In-111 pentetreotide SPECT and low-dose computed tomography (CT) for anatomic reference. De- spite its low degree of differentiation, the tumor showed high tracer uptake characterized by a positive incremental trend as shown by comparison of the 4-hour and 24-hour SPECT images, suggesting specific receptorial binding of In-111 pentetreotide.
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