Somatostatin Receptor-Expressing Hibernoma Mimicking Malignancy on SSTR-PET in MEN1: A Diagnostic Pitfall.
Daniel Rosok, Hubertus Hautzel, Stefanie Bertram et al.
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Case in brief
A 21-year-old woman with MEN1 underwent serial somatostatin receptor (SSTR) PET imaging after curative treatment of pancreatic neoplasia, which was in complete remission. An intramuscular lesion showed moderate SSTR expression and slow progressive growth. Heterogeneous enhancement and diffusion restriction on MRI raised concern for malignancy, but biopsy histopathology established the diagnosis of hibernoma, a benign tumor of brown adipose tissue.
What made this case unusual
The hibernoma expressed SSTR on PET, mimicking malignancy in a patient undergoing imaging surveillance for MEN1-associated pancreatic neoplasia.
Diagnostic / clinical pearl
SSTR uptake and concerning MRI features do not establish malignancy; correlate multimodality imaging with histopathology when an intramuscular lesion is suspicious.