Case Author(s): Jerold Wallis , 5/31/94 . Rating: #D3, #Q3

Diagnosis: VIPoma metastatic to liver

Brief history:

Patient with history of a VIPoma. Assess for residual disease


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Full history/Diagnosis is available below

Diagnosis: VIPoma metastatic to liver

Full history:

The patient is status post resection of a pancreatic VIPoma, and subsequent resection of a solitary liver metastasis one year ago. The patient now has recurrent symptoms. MR examination of the abdomen did not reveal any tumor foci.


There are two abnormal areas of increased radiopharmaceutical uptake in the liver, one near the junction of the right and left lobes, and the other in the posterior segment of the right liver lobe near the inferior liver edge. These almost certainly represent metastatic disease from the patient's prior VIP secreting tumor.


Octreotide imaging is useful for detecting a variety of neuro-endocrine tumors which contain somatostatin receptors, including VIPomas, insulinomas, gastrinomas and pheochromocytomas.


An angiographic CT examination confirmed the two liver lesions, and also demonstrated several additional small lesions within the liver.

Major teaching point(s):

Uptake at the inferior liver margin on the planar images could have been due to (normal) hepatobiliary excretion of tracer. SPECT is useful to localize this activity further; the relatively posterior location suggests a tumor focus within the liver.

ACR Codes and Keywords:

References and General Discussion of Octreotide Scintigraphy (Anatomic field:Gasterointestinal System, Category:Neoplasm, Neoplastic-like condition)

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Case number: ot001

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