A case of metastatic lymphoepithelial carcinoma of parotid gland identified on 68Gallium-DOTATATE PET CT

Abstract The authors present the case of a 59-year-old lady diagnosed with lymphoepithelial carcinoma (LEC) of the left parotid gland. The primary tumor was identified using contrast-enhanced CT, and diagnosis was confirmed via fine needle aspiration cytology and immunohistochemistry. Staging using 18F-FDG PET CT revealed regional nodal metastases, while no distant metastasis was evident. Following radical radiotherapy, a favorable locoregional response was observed on MRI, yet the patient's plasma Epstein-Barr virus load continued to rise. Given her primary tumor's somatostatin receptor type 2 (SSTR2) positivity, 68Ga-DOTATATE PET CT was performed, revealing multiple distant metastases with DOTATATE avidity. Despite attempts at palliative chemotherapy and immunotherapy, disease progression led to the decision for best supportive care. The unique presentation of metastatic LEC on 68Ga-DOTATATE PET CT suggests a potential role for SSTR2-targeted imaging in diagnosis and management.