68Ga-DOTATATE PET/CT Reveals Epstein-Barr Virus–Associated Nasopharyngeal Carcinoma in a Case of Suspected Sphenoid Wing Meningioma

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In this case of suspected sphenoid wing meningioma, 68Ga-DOTATATE PET/CT showed a somatostatin receptor (SSR)–expressing tumor with extension to the nasopharynx and SSR-expressing cervical lymph nodes. Subsequent biopsy from the nasopharynx revealed an Epstein-Barr virus (EBV)–associated, undifferentiated World Health Organization type 3 nasopharyngeal carcinoma (NPC), a potential clinical pitfall due to the reported high SSR expression of this tumor subtype. In consideration of the high target-to-background contrast, SSR ligands might be superior to 18F-FDG for EBV-associated NPC PET imaging, particularly at the skull base. Somatostatin receptor ligands might furthermore offer interesting theranostic possibilities for patients with advanced/extensive EBV-associated NPC.

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