Neo-adjuvant systemic radiation therapy for inoperable hepatic hilum neuroendocrine tumor with 177Lu- DOTATATE: successful final surgical resection

Document Type : Case report

Authors

1 Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Nuclear Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Abstract

The role of neoadjuvant therapy in neuroendocrine tumors (NET) remains an area requiring further advanced clinical exploration. 177Lu-DOTATATE has demonstrated significant therapeutic efficacy in managing metastatic NET, with reports of notable tumor size reduction in specific cases. This report highlights the case of a young patient diagnosed with an initially inoperable hepatic hilum NET. The patient received two cycles of 177Lu-DOTATATE, resulting in remarkable tumor shrinkage on follow-up imaging, which facilitated surgical intervention. The patient underwent a complex left trisectionectomy resection, including anastomosis of the right portal vein, resection and interposition graft of the right hepatic artery, Roux-en-Y hepaticojejunostomy, and jejunojejunostomy. Due to residual involvement of the common hepatic duct and right portal vein margins, two additional cycles of adjuvant 177Lu-DOTATATE were administered post-surgery. Long-term follow-up imaging over a 20-month period has demonstrated stable disease, emphasizing the potential benefits of incorporating neoadjuvant and adjuvant 177Lu-DOTATATE in selected NET cases.

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References

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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 14, Issue 1
January 2026
Pages 107-111

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