60-year-old male patient:
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Diarrhea, postprandial dizziness and weakness
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Weight loss of 20 kgs in the last 2 years
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CT imaging was acquired
What do you see?
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Mesenteric mass with calcifications surrounded by tethered small bowel loops
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Retroperitoneal lymphadenopathy
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Hypodense hepatic lesion, most likely metastasis
What is the most likely diagnosis?
Mesenteric, retroperitoneal lymph node and hepatic metastasis of small bowel neuroendocrine tumor (NET)
Most commonly, this tumor originates in the terminal ileum, but in many cases, the submucosal primary lesion can’t be identified on CT
The mesenteric mass shows both calcifications and tethering of the surrounding bowels due to the characteristic desmoplastic reaction of the mesentery
For further work-up, the radiotracer Ga-68 DOTATATE is shown to be the most accurate at identifying NET