MOLECULAR IMAGING AND THERAPY IN AN UNRESPONSIVE CASE WITH MULTISYSTEMIC METASTATIC ILEAL NEUROENDOCRINE TUMOR.

We aim to describe a patient diagnosed with a rare and aggressive metastatic pattern of an ileal neuroendocrine tumor (NET). A 53-year-old male patient was referred to our cancer care center following the diagnosis of an ileal NET for further evaluation. As part of the initial diagnostic workup, 68Ga-DOTATOC positron emission tomography/computed tomography was conducted. The scan revealed a fulminant metastatic pattern of somatostatin-positive lesions affecting the axial and peripheral skeleton, liver, and a few lesions involving the brain leptomeninges and right extra-orbital eye muscle. Despite the prompt diagnosis and systematic therapeutic approach offered according to institutional guidelines, the patient did not achieve an optimal clinical response, resulting in his demise 18 months after his initial diagnosis. This case is shared with the primary aim of raising awareness of such an unreported aggressive metastatic pattern and encouraging further clinical investigations for patients with similar aggressive metastatic patterns to achieve optimal therapy and care.