Intraoperative Radioguided Localization of an Occult Neuroendocrine Tumor of the Ileum

We report the intraoperative radioguided localization of an occult well-differentiated neuroendocrine tumor of the ileum in a patient with a known neuroendocrine lymphonodal metastasis in the mesentery. Preoperative imaging included CT, PET/CT with Ga-68-DOTATOC, and SPECT/CT with Tc-99m-HYNICTOC. These scans revealed morphological and functional properties of the primary tumor localized in the ileum. The day after IV Tc-99m-HYNICTOC injection, the patient underwent surgery, and the target lesion was intraoperatively detected by a collimated handheld gamma-probe. Postoperative pathology examination confirmed the target lesion to be a neuroendocrine tumor of the ileum.