case_images: PMC10625823_01
case_images: Chest-abdomen-pelvis computed tomography (CT) scan. Coronal (a, b) and axial (c, d) CT projections showing a voluminous abdominal mass (mesenteric tumor) of 126 x 96 mm, and liver tumor of 213 mm x 155 mm in both lobes with significant contrast enhancement due to hypervascularization (a-d).
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case_images: F1
case_images: A simple and contrast-enhanced CT scan of the abdomen and pelvis reported a mesenteric tumor of 126 x 96 mm, hepatomegaly, and a liver tumor of approximately 20 cm in both lobes (Fig. 1).
case_images: a The microscopic study showed small, blue, round tumor cells disposed in cords, festoons, and glandular formation. b, c The tumor cells are small with uniform nuclei, round/oval with salt, and pepper chromatin and inconspicuous nucleoli. Immunohistochemistry revealed positive staining for CKAE1/AE3 in the cellular membrane (d), chromogranin with granular cytoplasmic pattern (e), and CD99 in the cellular membrane (f).
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case_images: F2
case_images: High-grade NEC of the small cell type of liver was reported (Fig. 2).
case_images: Tumor resection. a A tumor is observed at the level of the mesentery. b Complete removal of the 130 x 100 mm mesentery tumor. c Macroscopically without evidence of residual disease at the level of the mesentery.
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case_images: F3
case_images: Eight months ago, an exploratory laparotomy was performed, with complete removal of mesentery tumor (Fig. 3).
case_images: Gallium-68 DOTATATE positron emission tomography (PET)/computed tomography (CT) scan demonstrating increased DOTATATE uptake (SUVmax 20.7) in the right lobe of the liver of 12 x 18.9 x 28.6 cm, and increased DOTATATE uptake (SUVmax 14.2) in the left lobe of 6.2 cm x 0.5 cm, as shown in coronal (a) and transaxial (b-d) views. No evidence of tumor in mesentery.
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case_images: F4
case_images: SUV max of 20.7, and another tumor in the left lobe of 6.2 cm x 0.5 cm, SUV max of 14.2, but no evidence of tumor in mesentery. Stable disease was concluded based on the response evaluation criteria in the solid tumor guide version 1.1 (RECIST 1.1) (Fig. 4).