Somatostatin receptor scintigraphy in a patient with and epigastric mass and multiple liver metastases

A patient with an epigastric mass and multiple liver metastases with a histopathologic diagnosis of adenocarcinoma was treated with combined chemohormonal therapy. She had a poor response, despite intense and repeated treatment. Somatostatin receptor scintigraphy with In-111 pentetreotide demonstrated the presence of somatostatin receptors in the primary lesion and in the liver metastasis, suggesting the tumor was of neuroendocrine nature. This finding led to a sudden change in treatment as a result of the beneficial use of octreotide, and to a revision in the diagnosis with pathologic recognition of a carcinoid. This case underlines the clinical impact of somatostatin receptor scintigraphy in patient management by providing information on the somatostatin receptor status of the tumor.