# Gluteal hemangioma mimicking a neuroendocrine tumor: pitfalls in neuroendocrine tumor diagnostic testing

## TL;DR

A patient's gluteal hemangioma was mistaken for a neuroendocrine tumor due to a positive scan and blood tests, highlighting diagnostic challenges.

## Contribution

This case highlights the diagnostic pitfall of misinterpreting hemangiomas as neuroendocrine tumors using somatostatin receptor scanning.

## Key findings

- A gluteal hemangioma was misdiagnosed as a neuroendocrine tumor based on a 68Ga-DOTATATE scan and blood tests.
- The hemangioma expressed SSTR2 in endothelial cells, mimicking a neuroendocrine tumor.
- Hemangiomas are common mimics of NETs and should be considered in unusual anatomical locations.

## Abstract

Somatostatin receptor scanning with radiolabeled somatostatin analogues is an important modality for localizing neuroendocrine tumors (NETs) but may also show activity in normal tissues and non-NET pathologies. A patient with a history of a parathyroid adenoma, papillary thyroid carcinoma, and acoustic neuroma was suspected of harboring a NET based upon 2 circulating tumor nucleic acid tests that used different methodology and a positive 68gallium-dodecanetetraacetic acid-tyrosine-3-octreotate (68Ga-DOTATATE) scan corresponding to a 2.2-cm right gluteal mass, which was found to be an intramuscular hemangioma expressing somatostatin receptor 2 subtype (SSTR2) in the endothelial cells. Hemangiomas are among the most frequently reported lesions mimicking a NET and should be considered when somatostatin receptor scanning localizes an isolated lesion in an unusual anatomic area.