PMC5798102_01
Fluorodeoxyglucose-positron emission tomography-computed tomography shows large hypodense, enhancing, hypermetabolic lesion involving the right lobe of liver, suggesting metastatic disease (a-c; transaxial computed, tomography, positron emission tomography-computed tomography and maximum intensity projection images, respectively)
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F1
CECT revealed large hypodense enhancing lesion involving the right lobe of the liver and FDG-PET-CT showed them to be hypermetabolic, suggesting to be of a metastatic disease [Figure 1a-c].
No abnormal rejection activity index accumulation noted in liver (a and b; anterior and posterior images, respectively)
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F2
I-131 whole body scan did not show any abnormal concentration in the liver [Figure 2a and b; anterior and posterior images, respectively]. In view of normal
The histopathology reveals neuroendocrine tumor cells (a and b), immunopositive for chromogranin and synaptophysin (c and d, respectively)
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F3
To confirm the diagnosis, a repeat liver biopsy was planned at our institute. The histopathology revealed neuroendocrine tumor (NET) cells [Figure 3a and b] which were immunopositive for chromogranin and synaptophysin [Figure 3c and d, respectively].
68-Ga-DOTANOC positron emission tomography-computed tomography shows somatostatin receptor expressing tumor in both lobes of liver with extensive skeletal metastasis (a-c; transaxial computed tomography, positron emission tomography-computed tomography and maximum intensity projection images, respectively)
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F4
Subsequently, a 68-Ga-DOTANOC PET-CT was planned which showed somatostatin receptor expressing tumor in both lobes of the liver with extensive skeletal metastasis [Figure 4a-c; transaxial CT, PET-CT, and maximum intensity projection images, respectively].