A 72-year-old woman with metastatic, well-differentiated, small intestinal neuroendocrine tumor (NET) presented for routine follow-up in September 2020 with worsening fatigue and flushing. She was initially diagnosed with metastatic involvement of the liver, bone, and intra-abdominal lymph nodes in 2015 and received 3 treatments with peptide receptor radionuclide therapy (PRRT) in 2017. After 2 years of disease stability she was retreated with PRRT in November 2019 because of radiographic progression of disease and worsening symptoms. A third dose of PRRT was given in March 2020; a fourth was deferred owing to persistent thrombocytopenia after treatment. Gallium 68 dotatate positron emission tomography–computed tomography in July 2020 revealed stable disease (Figure, A).