Clinical impact of 68Ga-DOTATOC PET on treatment decisions in jugulotympanic paragangliomas: A case series

Abstract

The study aimed to highlight the complementary roles of computed tomography (CT), magnetic resonance imaging (MRI), and gallium-68 DOTA-(Tyr³)-octreotide positron emission tomography (⁶⁸Ga-DOTATOC PET) in the diagnosis and treatment of jugulotympanic paragangliomas. We present cases of three patients: a 48-year-old woman with tympanic paraganglioma associated with left facial paralysis (patient 1), a 60-year-old man with asymptomatic jugular paraganglioma (patient 2), and a 73-year-old woman with a small tympanic paraganglioma (patient 3). All patients underwent CT, MRI, and ⁶⁸Ga-DOTATOC PET imaging. Tumor localization, extent, and anatomical relationships were assessed using CT and MRI. Functional confirmation of neuroendocrine tumor identity and exclusion of multifocal or metastatic disease were achieved through ⁶⁸Ga-DOTATOC PET. CT and MRI provided high-resolution anatomical details. ⁶⁸Ga-DOTATOC PET demonstrated intense radiotracer uptake in all lesions, including a 4-mm lesion in patient 3, with no evidence of multifocality or metastasis. Patient 1 underwent complete tumor resection with facial nerve reconstruction. Patient 2 was treated with radiotherapy. Patient 3 underwent transcanal resection with ossicular preservation. In conclusion, ⁶⁸Ga-DOTATOC PET serves as a valuable adjunct to CT and MRI for evaluating jugulotympanic paragangliomas, confirming diagnosis, and supporting precise treatment planning.