Medical Radiology and Radiation Safety. 2016. Vol. 61. No. 4. P. 76-82

MEDICAL PRACTICE ISSUE

A.N. Bashkov¹, Z.V. Sheykh², E.A. Ionova¹, S.A. Mirzoyants¹, N.S. Drebushevskiy¹, O.O. Grigor’eva¹, A.P. Dunaev¹

Unique Case of Giant Exophityc Solitary Liver Metastasis of Neuroendocrine Cancer of Small and Large Intestine

1. A.I. Burnasyan Federal Medical Biophysical Center of FMBA, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. S.P. Botkin City clinical hospital Moscow, Russia.

ABSTRACT

Purpose: To present a rare case of a giant solitary metastasis of the liver with exophytic growth pattern in a patient with neuroendocrine cancer of small intestine and colon, to demonstrate coordinated work of radiology department.

Material and methods: Computer tomography with bolus intravenous administration of 100 ml of contrast agent Ultravist-370 on multislice CT Aquilion 64; whole body scintigraphy on SPECT Philips with intravenous administration of 218.0 MBq ¹¹¹In-octreotide.

Results: Яmputer tomography revealed a mass in the ileocecal region, which had features of carcinoid, and also a large exophytic solid mass in the left lobe of the liver observed since year 2011. The mass in the liver was solitary, with exophytic growth and heterogeneous structure, much more than the mass in the ileocecal region, maximal accumulate of the contrast agent at the venous phase; thus we thougth of the differential diagnosis between primary tumor and liver metastasis. It was recommended to perform ¹¹¹In-octreotide SPECT in connection with suspected neuroendocrine cancer. The study has confirmed neuroendocrine nature of masses in the ileocecal region and liver, as well as the accumulation of a specific agent in the sigmoid colon, where was a colonoscopy found polyps. The histopathological study after surgery confirmed neuroendocrine cancer of the small and large intestine with liver metastasis.

Conclusion: 1. A rare case of a giant solitary metastasis of the liver with exophytic growth pattern in a patient with neuroendocrin cancer of small intestine and colon was presented. 2. Data from computer tomography and single photon emission tomography allow to make correct diagnosis at the stage of preoperative examination, despite the atypical signs of the solid mass in the liver.

Key words: neuroendocrine cancer, carcinoid, multidetector spiral computed tomography, single photon emission computed tomography, a solitary exophytic metastasis

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For citation: Bashkov AN, Sheykh ZV, Ionova EA, Mirzoyants SA, Drebushevskiy NS, Grigor'eva OO, Dunaev AP. Unique Case of Giant Exophityc Solitary Liver Metastasis of Neuroendocrine Cancer of Small and Large Intestine. 2014;61(4):76-82. Russian.

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