Background: Functional imaging with 68Ga-DOTATATE PET-CT is widely employed
to detect both primary and metastatic pheochromocytomas and paragangliomas (PGL), but its results
may be occasionally misleading as in the case here reported.
Case Presentation: We report here a 75-year-old woman with an interaortocaval PGL that was diagnosed
after a hypertensive crisis occurring during the resection of a kidney tumor. 68Ga-DOTATATE
PET-CT disclosed pathologic uptake in the abdomen and at the iliac crest. After the resection
of the abdominal tumor, with the histological confirmation of PGL, arterial blood pressure and
metanephrine levels were normalized. Genetic testing was negative. Thereafter, the bone lesion increased
in size and became painful, requiring multiple medications. A selective biopsy disclosed a
metastatic lesion arising from the renal tumor.
Conclusion: The false-positive result of 68Ga-DOTATATE PET-CT is discussed.