Abstract
Traditionally, functional imaging with somatostatin receptor analogues is used in the primary diagnostics, staging, and monitoring of neuroendocrine tumors (NETs) as well as to asses the potential effect of treatment with (radioactive) somatostatin analogues. We report a case in which a woman was diagnosed with a low grade NET in a liver biopsy, but results from the diagnostic work-up pointed towards a synchronous, high grade, metastasizing malignancy. Because of the patient’s poor general health, invasive procedures were deemed unattainable. Somatostatin receptor scintigraphy with the tracer 111 In-pentetreotide was therefore used as a very specific method of establishing the neuroendocrine nature of all the lesions found, and hence, palliative treatment could be commenced. This case thereby illustrates the feasibility of using somatostatin receptor imaging to establish the neuroendocrine nature of metastases suspected of originating from a synchronous high grade malignancy, when a low grade neuroendocrine tumor has been diagnosed elsewhere and invasive procedures are not possible.
Highlights
Different imaging modalities may be of use in unclarified disease states
We report a case in which a woman was diagnosed with a low grade neuroendocrine tumors (NETs) in a liver biopsy, but results from the diagnostic work-up pointed towards a synchronous, high grade, metastasizing malignancy
NETs originate from cells of the neuroendocrine system
Summary
Different imaging modalities may be of use in unclarified disease states. Positron emission tomography (PET) with F-18fluorodeoxyglucose (F-18-FDG) depicts cellular glucose metabolism with a high uptake being indicative of a high cellular turnover and, consistent with ongoing infection, inflammation, or high grade malignancy (Hess, et al, 2014). Functional imaging with somatostatin receptor analogues is used in the primary diagnostics, staging, and monitoring of neuroendocrine tumors (NETs) as well as to assess the potential effect of treatment with (radioactive) somatostatin analogues. We report a case in which a woman was diagnosed with a low grade NET in a liver biopsy, but results from the diagnostic work-up pointed towards a synchronous, high grade, metastasizing malignancy.
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