Epidural Metastases From Follicular Thyroid Cancer Mimicking Meningiomas in 68Ga-DOTATATE PET

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We report a woman with multifocal lesions suggestive of meningiomas in MRI, which also presented with high 68Ga-DOTATATE uptake in PET, a finding characteristic for meningioma. A whole-body staging due to a pathological fracture revealed multiple neoplastic lesions throughout the body without detection of a primary site. Subsequent pathological workup of a lung lesion revealed multifocal metastases from follicular thyroid cancer despite thyroidectomy 10 years ago (without pathological finding), and posttreatment scans after radioiodine therapy confirmed the multiple brain lesions to be metastases as well. Our case shows that epidural metastases from endocrine origin might represent a clinical pitfall in 68Ga-DOTATATE PET.

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