Disseminated neuroendocrine tumor in a young male with weight loss

Abstract

A 34-year-old male presented with weight loss of 10 kg in the last 3 months. There was no abdominal pain, fever, jaundice, or gastrointestinal bleeding. On routine laboratory investigation, there was microcytic anemia with hemoglobin of 8.5 g/dl. On ultrasound examination, there were abdominal lymph adenopathy and left adrenal enlargement. Endoscopic ultrasound was done which revealed multiple hypoechoic lesions in liver; abdominal lymphadenopathy and bulky left adrenal fine needle aspiration were taken from periportal lymph node and adrenal using a 22-gauge needle; cytopathology report was suggestive of neuroendocrine tumor, Grade 2. A DOTA scan was done for defining extent which revealed DOTA avid lesion in the right middle lung, mediastinal and abdominal lymph nodes, multiple liver space-occupying lesions, and bilateral bulky adrenal. He was finally diagnosed as lung neuroendocrine tumor with disseminated metastasis.