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04 September 2020 : Case report  Poland

Atypical Enhancement of Gd-BOPTA on the Hepatobiliary Phase in Hepatic Metastasis from Carcinoid Tumor – Case Report

Unknown etiology, Mistake in diagnosis

Patryk Pozowski1E*, Paula Misiak2E, Kinga Szymańska1ABF, Rafał Mazur1B, Małgorzata Sierpowska3C, Jurand Silicki1D, Milena Celmer1F, Mateusz Łasecki1A, Aleksander Pawluś1B, Urszula Zaleska-Dorobisz1G

DOI: 10.12659/AJCR.924280

Am J Case Rep 2020; 21:e924280

Abstract

BACKGROUND: Carcinoid tumor is the most frequent neuroendocrine tumor (NET) that causes liver metastases. One of the best methods to assess this type of pathology is magnetic resonance imaging with hepatocyte-specific contrast media with low molecular weight gadolinium chelate Gd-BOPTA. As these lesions do not contain hepatocytes, they present as hypointense on MRI in comparison with liver tissue which enhances this type of contrast.

CASE REPORT: In this article, we present a case of a 65-year-old female patient who was admitted to the Emergency Department with abdominal pain. Computed tomography revealed a single focal lesion in her liver. The patient underwent further evaluation using magnetic resonance imaging (MRI). The hepatobiliary phase MRI showed an unspecific homogenous enhancement of the hepatobiliary agent Gd-BOPTA. Since the lesion was interpreted as a non-characteristic lesion, the patient was discharged from the hospital with a recommendation for early follow-up. The follow-up MRI 6 months after discharge disclosed multiple liver metastases.

CONCLUSIONS: Liver metastases generally demonstrate enhancement of hepatobiliary contrast agents in the T1-weighted hepatocellular phase. Metastasis from a carcinoid tumor may also demonstrate this enhancement.

Keywords: Carcinoid Tumor, Contrast Media, Magnetic Resonance Imaging, Neoplasm Metastasis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923