False positive localization of primary mesenteric neuroendocrine tumor to the pancreas with Ga-DOTATATE PET–CT changing the surgical management

Abstract Neuroendocrine tumors (NETs) are a group of neoplasms that arise from the neural crest. They can be predominantly found in the gastrointestinal tract, pancreas, lung and rarely in the ovary and thymus. The introduction of β emitting 68 Ga-radiolabelled-DOTA peptides in PET–CT for the imaging of NETs has been giving promising results. But, it is worthwhile to know the limitations of using Ga-DOTA peptides to minimize the occurrence of false positives. We report an interesting case of a primary mesenteric neuroendocrine tumor that was misdiagnosed as a nodal secondary from a falsely localized primary pancreatic NET as a result of non-specific physiologic Ga-DOTA uptake in the pancreas. This resulted in an unnecessary distal pancreatectomy.