The impact of high-end ultrasound in the management of a patient with neuroendocrine tumor of the ileum

Abstract

Diagnostic imaging of jejuno-ileal neuroendocrine tumors (NETs) has been described as challenging. Follow-up requires the detection of metastatic spread as well as screening for local recurrence. Multimodal imaging concepts must often be applied.

We report the case of a 45-year-old man with a history of ileal NET. At 2 points in follow-up of our patient, information provided by high-end ultrasound changed prognosis and treatment considerably: when positron emission tomography/computed tomography newly detected suspected hepatic metastases, contrast-enhanced ultrasound correctly identified the lesions as intrahepatic vascular shunts. Moreover, profound B-mode ultrasound solely detected ileal recurrence, leading to early removal of the tumor.

Zusammenfassung

Diagnostische Bildgebung bei jejuno-ilealen neuroendokrinen Tumoren (NETs) stellt gemeinhin eine Herausforderung dar. In der Nachsorge ist sowohl auf die Detektion möglicher Metastasen als auch auf das Auftreten von Lokalrezidiven zu achten. Oft sind hierfür multimodale bildgebende Ansätze notwendig.

Wir berichten über den Fall eines 45-jährigen Patienten mit einem ilealen NET in der Vorgeschichte. An zwei Punkten in der Nachsorge des Patienten lieferte high-end Ultraschall Informationen, die sowohl die Prognose als auch das Behandlungskonzept des Patienten maßgeblich beeinflussten. Im PET/CT neu aufgetretene und als hoch metastasensuspekt beschriebene Läsionen wurden im CEUS korrekt als intrahepatische vaskuläre Shunts erkannt. Des Weiteren detektierte fundierter B-Bild-Ultraschall als einziger ein ileales Rezidiv des NET, was eine frühe Resektion des Tumors ermöglichte.

Key words

neuroendocrine tumor (NET) - jejuno-ileal neuroendocrine tumor (Si-NET) - ultrasound (US) - contrast-enhanced ultrasound (CEUS)

Schlüsselwörter

Neuroendokriner Tumor (NET) - jejuno-ilealer neuroendokriner Tumor (Si-NET) - Sonografie (US) - Kontrastmittel-Sonografie (CEUS)

^* These authors contributed equally

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