Contrast-Enhanced Ultrasound and Somatostatin Receptor Scintigraphy Unveil an Occult Neuroendocrine Tumor With Carcinoid Syndrome and Presumed Small Intestinal Origin – A Case Report
Year: 2025
Type: article
Study design: Case Report
Abstract: A 68-year-old man with postprandial flushing and palpitations was referred for multiple hepatic lesions. Computed tomography showed hypoattenuating metastases without a detectable primary, whereas contrast-enhanced ultrasound revealed arterial hyperenhancement and Kupffer-phase defects, indicating hypervascularity typical of neuroendocrine tumors (NETs). Urinary 5-hydroxyindoleacetic acid elevation, together with liver biopsy findings, confirmed a well-differentiated NET (grade 2), presenting with carcinoid syndrome. Somatostatin receptor scintigraphy demonstrated diffuse hepatic uptake and a mesenteric focus, suggesting a small intestine origin. Lanreotide was initiated, achieving partial symptom improvement and radiologic stability. This case highlights contrast-enhanced ultrasound for demonstrating hypervascularity and somatostatin receptor scintigraphy for localizing an occult origin in NET.
Source: Gastro Hep Advances
Authors: Tairyu Sato, Akira Nishio, Tadashi Kegasawa, Kazuna Hazu, Chihiro Tarumi, Koki Yamada, Yuki Nishiura, Kumi Higashihara, Shogo Nagahama, Takayuki Matsumae, Yuki Tokuda, Aya Ishimi, Satoshi Hiyama, Masafumi Ogata, Chiaki Nakai, Keitaro Masuko, Katsumi Yamamoto, Nobuyuki Tatsumi, Yasuyuki Yoshida, Kayako Isohashi, Yoshito Hayashi, Akira Kaneko
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W7115690451