Neo-Adjuvant Systemic Radiation Therapy for Inoperable Hepatic Hilum Neuroendocrine Tumor With 177Lu-Dotatate: Successful Final Surgical Resection Publisher



Moradi AM ; Sharifian F ; Farzanefar S ; Ghasri MR ; Abbasi M
Source: Asia Oceania Journal of Nuclear Medicine and Biology Published:2026

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. © 2026 mums.ac.ir All rights reserved.