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A Case of Metastatic Malignancy Masquerading as a Hepatic Hemangioma on Labeled Red Blood Cell Scintigraphy

Department of Nuclear Medicine and Ultrasound, Department of Surgery and Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia

Correspondence: For reprints or correspondence contact: Dr. David Farlow, Department of Nuclear Medicine and Ultrasound, Westmead Hospital Westmead NSW 2145, Australia.

ABSTRACT

A 36-yr-old woman with a past history of gastric neuro-endocrine carcinoma (carcinoid tumor) underwent ^99m-red blood cell (ABC) scintigraphy for evaluation of a 2-cm echogenic liver mass demonstrated on ultrasound. Scan findings were typical of a cavernous hemangioma. On follow-up, however, there was progressive lesion enlargement; histopathology of the resected mass revealed neuro-endocrine carcinoma. This case report, one of the few examples of a false-positive ^99mTc-RBC scan, highlights the need for cautious evaluation of focal liver masses, even when there are typical scintigraphic features of cavernous hemangioma.