Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 7 2015 06 10 Metastatic Nonfunctional Pancreatic Neuroendocrine Tumor - Case Report and Review of the Literature 205 208 EN Ludmila Tankova Vanya Gerova Plamen Getsov Radislav Nakov Clinical Center of Gastroenterology, University Hospital, "Queen Joanna", Sofia, Bulgaria Stanislav Churchev Ivan Terziev Irena Kostadinova Miroslava Vitkova Ventsislav Nakov Damyan Damyanov Nina Topuzanska AJMCR2015376 10.12691/ajmcr-3-7-6 2015 05 31 2015 06 02 2015 06 10 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.