Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

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

Document Type : Case report

Authors
Ali Mohamad Moradi 1
Fatemeh Sharifian 2
Saeed Farzanefar 2
Mohammad Reza Ghasri 2
Mehrshad Abbasi 2
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
10.22038/aojnmb.2025.85403.1614
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.
Keywords
Inoperable tumor treatment
Radiation therapy
Neuroendocrine tumor resection
Neoadjuvant therapy
Subjects
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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 14, Issue 1
January 2026
Pages 107-111