Breast metastasis from the pancreatic neuroendocrine tumor origin detected by 99mTc-Octreotate scan

A 50 years old woman with history of pancreatic neuroendocrine tumor diagnosed 2 years ago, which has not been surgically removed,was referred to our department for a 99mTc-Octreotate in order to evaluate the somatostatin receptor status. She was treated with regular sandostatin injections and chemotherapy. Her CT scan which was previously performed confirmed lung, adrenal and hepatic metastases. In her original pancreatic mass biopsy, well-differentiated neuroendocrine tumor of the pancreas with 3% rate of KI-67 positivity was reported. Whole body 99mTc-Octreotate scan was obtained 4 hours post-intravenous injection of 20 mCi of the radiotracer showed multiple areas of increased tracer uptake in the pancreas, left adrenal, both breasts and left axillary region. Considering the fact that metastasis of the pancreatic NET to the breast is extremely rare, we recommended mammographic correlation and tissue biopsy. Her CT scan images and mammography confirmed breast masses and the biopsy revealed metastatic NET from the pancreatic origin.