title: Solitary hypervascular liver metastasis from neuroendocrine tumor mimicking hepatocellular cancer: All that glitters is not gold.
abstract: 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.
authors.affiliation: Department of Radiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.
authors.forename: Shalini Thapar
authors.initials: ST
authors.lastname: Laroia
authors.affiliation: Department of Hepato-Pancreatico-Biliary and Liver Transplantation Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.
authors.forename: Shridhar
authors.initials: S
authors.lastname: Sasturkar
authors.affiliation: Department of Pathology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Rastogi
authors.affiliation: Department of Hepato-Pancreatico-Biliary and Liver Transplantation Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.
authors.forename: Viniyendra
authors.initials: V
authors.lastname: Pamecha
keywords: Computed tomography; DOTA-NaI-octreotide positron emission tomography; hepatocellular carcinoma; immunohistochemistry; magnetic resonance imaging; neuroendocrine tumor