Open AccessSolitary hypervascular liver metastasis from neuroendocrine tumor mimicking hepatocellular cancer: All that glitters is not gold
Author(s) -
Shalini Thapar Laroia,
Shridhar Vasantrao Sasturkar,
Archana Rastogi,
Viniyendra Pamecha
Publication year - 2015
Publication title -
indian journal of nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 13
eISSN - 0972-3919
pISSN - 0974-0244
DOI - 10.4103/0972-3919.147535
Subject(s) - medicine , hepatocellular carcinoma , neuroendocrine tumors , metastasis , radiology , histopathology , positron emission tomography , pathology , primary tumor , cancer
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.