False-Positive Gallium-68 DOTATATE PET/CT in Vertebral Hemangioma

A healthy 52-year-old man started to have few minutes spells of palpitation, tachycardia, hot flashes, and chest tightness. He had a lab work-up for carcinoid, including 5-hydroxyindoleacetic acid (5-HIAA), which was negative. Months later, his symptoms became worse which warranted further investigation to exclude carcinoid disease. Gallium-68 DOTATATE positron emission tomography combined with computed tomography (PET/CT) scanning was performed to assess the patient for carcinoid tumor. It showed foci of radiotracer avidity in the thoracic and lumber spine. Magnetic resonance imaging (MRI) for the vertebral lesions showed atypical hemangioma. Subsequently, follow-up serum chromogranin A testing was negative.