A case of renal primary neuroendocrine tumor (G3) in which 177Lu-PRRT was effective for disease control

Primary renal neuroendocrine tumor (NET) is extremely rare, with no established treatment for advanced cases. We report high-grade (G3) renal NET effectively treated with peptide receptor radionuclide therapy (PRRT). A 30-year-old man was diagnosed with primary renal NET G3 with liver metastases. After everolimus failure, he received 177Lu-DOTATATE (Lutathera®). Although the tumor continued growing after the first cycle, disease stabilized from the second cycle onwards. Stable disease was maintained for 12 months without severe adverse events, preserving quality of life. 177Lu-PRRT is a promising therapeutic option for high-grade, somatostatin receptor-positive renal NET when other treatments fail.