eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2015-06-10 3 7 205 208 10.12691/ajmcr-3-7-6 AJMCR2015376 article Ludmila Tankova 1 Vanya Gerova 1 Plamen Getsov 2 Radislav Nakov radislav.nakov@abv.bg 2 Stanislav Churchev 2 Ivan Terziev 3 Irena Kostadinova 4 Miroslava Vitkova 4 Ventsislav Nakov 4 Damyan Damyanov 4 Nina Topuzanska 4 Clinical Center of Gastroenterology, University Hospital, "Queen Joanna", Sofia, Bulgaria Department of Radiology, University Hospital, "Queen Joanna", Sofia, Bulgaria Department of Pathology, University Hospital, "Queen Joanna", Sofia, Bulgaria Medical University, Central Laboratory of Nuclear Medicine, Sofia, Bulgaria We present a 56-year-old patient with liver metastases from nonfunctional pancreatic neuroendocrine tumor. The disease is found incidentally in a patient with nonspecific symptoms. Conventional abdominal ultrasound establishes several liver lesions mimicking hemangiomas. On contrast enhancement ultrasonography hypervascularized secondary liver lesions are detected. Subsequent imaging methods and biochemical tests diagnose a pancreatic neuroendocrine metastatic tumor. Left-sided pancreatectomy with splenectomy is carried out. The patient is in good general condition six months after initiation of combination therapy with everolimus and sandostatin LAR depot. Tc-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging shows reduced accumulation of the radiopharmaceutical in the liver parenchyma without data of pancreatic tumor. http://pubs.sciepub.com/ajmcr/3/7/6/ajmcr-3-7-6.pdf neuroendocrine tumor pancreas liver metastases imaging methods