Exacerbation of Necrolytic Migratory Erythema after 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy

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Introduction: Necrolytic migratory erythema (NME) is an uncommon skin disorder which is characterized by deep erythematous plaques with superficial blistering, erosions and crusts. NME is a cutaneous manifestation of glucagonoma. Glucagonoma syndrome is a paraneoplastic disease, caused by an excessive secretion of glucagon by pancreatic alpha cells.

Aim(s): To report a case where an exacerbation of NME after peptide receptor radionuclide therapy (PRRT) led to the diagnosis of glucagonoma syndrome.

Materials and methods: A 57-year-old man was diagnosed with a pancreatic neuroendocrine tumor (pNET) 8 years prior, for which he was treated with curative surgery. After varying treatments, he presented with disease progression for which a first cycle of 177Lu-DOTATATE PRRT was administered. Three weeks later, a slightly scaling erythematous macular rash on the lower extremities and trunk appeared, which disappeared spontaneously after three weeks. Considering that our patient had a similar rash 8 years prior at the diagnosis of pNET, which resolved after subsequent surgery, we had a strong suspicion of NME secondary to glucagonoma.

Conference:

Presenting Author:

Authors: Ahmadi Bidakhvidi N, Vanden Bulcke A, Curvers S, de Haes P, de Hertogh G,

Keywords: glucagonoma, necrolytic migratory erythema, PRRT, 177Lu-DOTATATE, neuroendocrine tumor, pancreas,