Well-differentiated neuroendocrine carcinoma mimicking an echinococcus cyst of the liver in CT-MRI findings with hepatocyte specific contrast material

Gastroenteropancreatic neuroendocrine tumors and their metastases have an inconsistent appearance with only a small percentage of lesions appearing as cystic masses in computed tomography (CT) and magnetic resonance imaging (MRI) and can therefore be mistaken as benign or infectious lesions, leading to a false diagnosis with delayed and inadequate treatment. We report a patient with upper abdominal pain lasting for several months, caused by a huge cystic neuroendocrine carcinoma of the liver which was mistakenly interpreted as an echinococcus cyst and present the findings in the initial CT and the subsequently performed MRI under application of hepatocyte specific contrast material, which led to distinct differential diagnoses and therefore had a capacious impact on the therapeutic strategy.