PMC9922524_01
A) CT abdomen and pelvis with contrast displaying a lobulated soft tissue mass inferior to the pylorus measuring approximately 3.0 x 3.3 x 3.5 cm with possible connection with the adjacent bowel (red arrow). B) MRI of the abdomen showing a paraduodenal mass (red arrow). C) Histological slide demonstrating the surface duodenal mucosa and underlying organoid pattern of neuroendocrine tumor. D) Immunohistochemistry slide demonstrating the positivity of synaptophysin of the neoplastic cells.
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FIG1
The CT abdomen with contrast showed no evidence of acute traumatic injury to the chest, abdomen, or pelvis, an enlarged liver measuring 18 cm in craniocaudal dimension with diffuse fatty infiltration, no focal hepatic lesion, no biliary ductal dilatation, and a lobulated soft tissue mass inferior to the pylorus measuring approximately 3.0 x 3.3 x 3.5 cm with possible connection with the adjacent bowel but no evidence of bowel obstruction, bowel wall thickening or intraperitoneal free air (Figure 1A). The gastroenterology team was consulted for further evaluation of the mass and an esophagoduodenoscopy (EGD) was performed which was positive for Los Angeles (LA) Classification The next day the MRI of the abdomen with and without contrast was performed which was positive for a paraduodenal mass of unknown etiology and hepatic steatosis (Figure 1B).  Immunohistochemistry was positive for AE 1/3, CD56, Synaptophysin, and chromogranin and negative for CD117, DOG-1, CD34 and CD45 (Figure 1C, 1D).