Indian Journal of Nuclear Medicine
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Year : 2015  |  Volume : 30  |  Issue : 1  |  Page : 42-46

Solitary hypervascular liver metastasis from neuroendocrine tumor mimicking hepatocellular cancer: All that glitters is not gold

1 Department of Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
2 Department of Hepato Pancreatico Biliary and Liver Transplantation Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
3 Department of Pathology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India

Correspondence Address:
Dr. Shalini Thapar Laroia
L-1 Krishan Vatika, DLF Westend Farms, Mandi Road, Chattarpur, New Delhi - 110 030
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-3919.147535

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Neuroendocrine tumor metastases to the liver can mimic primary hepatocellular carcinoma (HCC) on imaging, cytology, and core biopsy. We present a case study along with the literature review of a patient who presented as a solitary liver mass mimicking HCC and subsequently underwent a partial hepatectomy. The histopathology and immunohistochemisrty of the resected specimen revealed metastatic neuroendocrine carcinoma. Positron emission tomography (PET) scan with 68 Ga-DOTA-NaI-octreotide ( 68 Ga-DOTANOC) localized the primary tumor in the ileum. A curative follow-up surgery for resection of the small bowel containing the primary tumor was carried out. This case illustrates the shortcomings of routine imaging methods, utility of immunocytochemistry and the importance of 68 Ga-DOTANOC PET in determining the metastatic spread as well as the origin of neuroendocrine tumors (NETs). This case report attempts to highlight the current imaging paradigms and management strategy of midgut and other NET's at the point of detection, staging and follow-up.

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