Case 252:   Metastasis - Neuroendocrine Tumor

Diagnostic Category:

Clinical Presentation:

46 year old man with recent unintentional weight loss and new diagnosis of diabetes mellitus.

MR: Hypervascular with central necrosis

Imaging Findings:

MR shows large heterogeneously hypervascular neuroendocrine metastasis (proven by octreotide scan, not shown here) with cystic spaces on T2w. The center of the mass is largely fibrotic, as the T2w images shows, but has not filled with contrast on the equilibrium image 5 minutes after administration. The prinmary tumor was a carcinoid tumor of the prepyloric segment of the antrum, partly shown here on the two coronal images.

Even though the metastasis has a somewhat stellate appearance and is hypervascular, it should not be confused with a large FNH, which would be homogeneously hypervascular and would have no heterogeneous T2w signal with cystic spaces.