Neuroendocrine tumors (NETs) are rare neoplasms arising from enterochromaffin cells, which are predominantly noted in the gastrointestinal tract and lung; metastases of NETs to the testes in NET are further uncommon. Testicular NET usually has no symptoms and/or presents with painless swelling of the scrotum. Detection of testicular lesion can be challenging and frequently missed on conventional radiological imaging. We present testicular NET missed on conventional radiological imaging, where 68 Ga-DOTATATE PET/CT imaging detected the testicular lesion, and further evident on 177 Lu-DOTATATE-based post-peptide receptor radionuclide therapy theranostic imaging.

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