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Pancreatoduodenal Neuroendocrine Tumor as an early manifestation of suspected MEN 1 Syndrome: The value of timely and multidimensional diagnosis – A case study Cover

Pancreatoduodenal Neuroendocrine Tumor as an early manifestation of suspected MEN 1 Syndrome: The value of timely and multidimensional diagnosis – A case study

Biuletyn Głównej Biblioteki Lekarskiej
Volume 58 (2025): Issue 384 (June 2025)
By: Aleksandra Nowakowska and  Michał Jędrzejewski  
Open Access
|Jun 2025

Figures & Tables

Figure 1.

MRI, T2-weighted, axial view – Abdominal cross-sectional T2-weighted MR image demonstrates a large, thickened, edematous gastric wall along the lesser curvature, with preserved rugal folds. This image is atypical for gastric cancer and raises differential diagnoses such as lymphoma, hypertrophic gastritis, or Zollinger-Ellison syndrome.
MRI, T2-weighted, axial view – Abdominal cross-sectional T2-weighted MR image demonstrates a large, thickened, edematous gastric wall along the lesser curvature, with preserved rugal folds. This image is atypical for gastric cancer and raises differential diagnoses such as lymphoma, hypertrophic gastritis, or Zollinger-Ellison syndrome.

Figure 2.

Axial fused [68Ga]Ga-DOTA-TATE PET/CT image at the level of the upper abdomen. Moderately increased radiotracer uptake is visible along the lesser curvature of the stomach near the cardiac orifice. This area corresponds to the gastric wall thickening visualized previously in the MRI, where a 106 × 34 mm lesion was seen. Although the uptake is not significantly intense, its location aligns with the previously identified abnormality. At the time of the MRI, differential diagnoses included gastric lymphoma, hypertrophic gastritis, and Zollinger-Ellison syndrome.
Axial fused [68Ga]Ga-DOTA-TATE PET/CT image at the level of the upper abdomen. Moderately increased radiotracer uptake is visible along the lesser curvature of the stomach near the cardiac orifice. This area corresponds to the gastric wall thickening visualized previously in the MRI, where a 106 × 34 mm lesion was seen. Although the uptake is not significantly intense, its location aligns with the previously identified abnormality. At the time of the MRI, differential diagnoses included gastric lymphoma, hypertrophic gastritis, and Zollinger-Ellison syndrome.

Figure 5.

[68Ga]Ga-DOTA-TATE PET/CT, axial plane-Fused PET/CT axial image showing increased somatostatin receptor expression in a well-defined lesion localized between the duodenum and the uncinate process of the pancreas, later confirmed as a neuroendocrine neoplasm. Additional focal uptake is visible in regional lymph nodes, suggesting possible metastases.
[68Ga]Ga-DOTA-TATE PET/CT, axial plane-Fused PET/CT axial image showing increased somatostatin receptor expression in a well-defined lesion localized between the duodenum and the uncinate process of the pancreas, later confirmed as a neuroendocrine neoplasm. Additional focal uptake is visible in regional lymph nodes, suggesting possible metastases.

Figure 3.

[68Ga]Ga-DOTA-TATE PET/CT, axial plane-increased focal uptake below the lower pole of the right thyroid lobe, which corresponds with a hyperactive parathyroid or parathyroid adenoma. Additionally, mild uptake was observed within two foci in the lower pole of the left thyroid lobe, which required further differentiation between an additional hyperactive parathyroid and a focal lesion in the thyroid.
[68Ga]Ga-DOTA-TATE PET/CT, axial plane-increased focal uptake below the lower pole of the right thyroid lobe, which corresponds with a hyperactive parathyroid or parathyroid adenoma. Additionally, mild uptake was observed within two foci in the lower pole of the left thyroid lobe, which required further differentiation between an additional hyperactive parathyroid and a focal lesion in the thyroid.

Figure 4.

[68Ga]Ga-DOTA-TATE PET/CT, axial plane-increased uptake in the pituitary gland, correlating with MRI findings of a suspected macroadenoma, in line with MEN 1 syndrome.
[68Ga]Ga-DOTA-TATE PET/CT, axial plane-increased uptake in the pituitary gland, correlating with MRI findings of a suspected macroadenoma, in line with MEN 1 syndrome.
DOI: https://doi.org/10.2478/bgbl-2025-0006 | Journal eISSN: 2956-6851 | Journal ISSN: 0373-174X
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Language: English
Page range: 61 - 68
Submitted on: May 22, 2025
Accepted on: May 30, 2025
Published on: Jun 17, 2025
Published by: The Medical Library named after S. Konopka in Warsaw
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year
Keywords:
Neuroendocrine neoplasm,
MEN 1 syndrome,
PET/CT DOTA-TATE,
pancreas,
duodenum,
stomach,
hyperparathyroidism
Related subjects:
Medicine,
Biomedical engineering

© 2025 Aleksandra Nowakowska, Michał Jędrzejewski, published by The Medical Library named after S. Konopka in Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.

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