DOTATATE Scan in Meningiomatosis in a Patient With Ophthalmoplegia

DOTATATE (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid [DOTA]-octreotate) is a compound that binds somatostatin receptors seen in tumors such as meningiomas. Here, we present a case of a patient with progressive bilateral ophthalmoplegia due to meningiomatosis involving both cavernous sinuses, which was highlighted by DOTATATE imaging. Some studies have shown DOTATATE imaging is superior to contrast-enhanced magnetic resonance imaging (MRI) in identifying extent of intraosseous meningioma growth, which has been associated with worse prognosis. DOTATATE imaging should be considered in cases of unknown diagnosis of mass lesions and lesions that are in areas not easily accessible to biopsy, such as the cavernous sinuses.