Gallbladder Neuroendocrine Tumor and 177 Lu DOTATATE: High Somatostatin Receptor Expression Without Clinical Response

Clin Nucl Med. 2026 Mar 1;51(3):e190-e192. doi: 10.1097/RLU.0000000000006001. Epub 2025 Jun 4.

Abstract

Gallbladder neuroendocrine tumors (GB-NETs) are rare, accounting for <0.5% of all NETs, and little is known about somatostatin receptor expression (SSTR) and its response to SSTR-targeted treatment such as Lutetium-177 ( 177 Lu) DOTATATE. 68 Ga DOTATATE PET/CT is a valuable imaging modality for SSTR expression and 177 Lu DOTATATE treatment planning. We present a case of a 74-year-old man with recurrent WHO grade 3 GB-NET. 177 Lu DOTATATE failed to control hepatic metastases despite high DOTATATE uptake, which led to treatment discontinuation. This case highlights the fact that positive SSTR imaging in GB-NETs does not always lead to a favorable response to 177 Lu DOTATATE.

Keywords: PET/CT; SPECT; gallbladder neuroendocrine tumor; lutetium-177.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Gallbladder Neoplasms* / diagnostic imaging
  • Gallbladder Neoplasms* / metabolism
  • Gallbladder Neoplasms* / pathology
  • Gallbladder Neoplasms* / radiotherapy
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Male
  • Neuroendocrine Tumors* / diagnostic imaging
  • Neuroendocrine Tumors* / metabolism
  • Neuroendocrine Tumors* / pathology
  • Neuroendocrine Tumors* / radiotherapy
  • Octreotide* / analogs & derivatives
  • Octreotide* / therapeutic use
  • Organometallic Compounds* / therapeutic use
  • Positron Emission Tomography Computed Tomography
  • Receptors, Somatostatin* / metabolism
  • Treatment Outcome

Substances

  • Receptors, Somatostatin
  • Octreotide
  • lutetium Lu 177 dotatate
  • Organometallic Compounds