68Ga-DOTANOC PET/CT in a Case of Grade 1 Pancreatic NET With Renal Vein and Gonadal Vein Tumor Thrombus

Pancreatic neuroendocrine tumors (PNETs) are uncommon neoplasms comprising approximately 1%-2% of all pancreatic malignancies. They display a wide clinical spectrum ranging from indolent, well-differentiated Grade 1 lesions to aggressive, poorly differentiated tumors. While metastatic spread to the liver is relatively common, vascular invasion and tumor thrombus formation are exceedingly rare in low-grade NETs. Here, we present an unusual postoperative case of a Grade 1 PNET with tumor recurrence, kidney infiltration, and tumor thrombus involving the left renal vein and extending into the gonadal vein.