Incidental Detection of Asymptomatic Brain Metastases on (18)F-fluoride Positron Emission Tomography/Computed Tomography and (68)Ga DOTANOC Positron Emission Tomography/Computed Tomography in a Patient with Concomitant Breast Carcinoma and a Pancreatic Neuroendocrine Tumor

A 54-year-old female treated for locally advanced ductal breast carcinoma was also diagnosed with a pancreatic neuroendocrine tumour. A staging (68)Ga DOTANOC positron emission tomography/computed tomography (PET/CT) demonstrated somatostatin receptor-positive foci within the brain parenchyma. A whole body (18)F-fluoride PET/CT also demonstrated several foci of low-grade tracer uptake in the brain. Magnetic resonance imaging confirmed several cerebral and cerebellar metastases. This case highlights the need to be aware of each tumor's metastatic profile and the careful attention required for thoroughly evaluating imaging in the presence of multiple pathologies. Furthermore, such incidental findings can have significant treatment and prognostic implications.