Neuroendocrine Tumor of the Palatine Tonsil Unmasked by 68Ga-DOTATATE PET/CT

A 63-year-old woman with metastatic neuroendocrine tumor in her abdominal wall received dual tracer PET/CT with 18 F-FDG and 68 Ga-DOTATATE for staging and finding the potential primary site. The 18 F-FDG PET/CT found metastases in her abdominal wall, mediastinal node, right adrenal and T 6 vertebra. Because of the high background activity, it missed the primary tumor in her left palatine tonsil. The 68 Ga-DOTATATE PET/CT found the primary tumor, which was confirmed by histopathology.