Neo-adjuvant systemic radiation therapy for inoperable hepatic hilum neuroendocrine tumourwith177Lu DOTATATE: successful final surgical resection

Articles in Press

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

3 Research institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

10.22038/aojnmb.2025.85403.1614

Abstract

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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Asia Oceania Journal of Nuclear Medicine and Biology

Articles in Press, Accepted Manuscript
Available Online from 27 October 2025

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