Liver mets mistaken as hemangioma or harmatoma on MRI

Hello @margaret12 and welcome to Mayo Clinic Connect. You have asked many questions about liver Mets and NETs. Are you asking on behalf of yourself or a family member?

You are looking for information about Gallium 69 as well as Copper 64. Have you had these diagnostic tests or has your doctor recommended one or both?

Here is some information from Mayo Connect about the Gallium 68 scan,
- FDG PET scan vs. 68Ga DOTATATE PET scan for neuroendocrine cancer
https://connect.mayoclinic.org/discussion/fdg-pet-scan-vs-68ga-dotatate-pet-scan-for-neuroendocrine-cancer/
What symptoms are you currently dealing with?

For myself. Extreme fatigue, had some upper abdomen pressure with enlarged CBD but that passed. Have choice of either Copper64 or Gallium68 (concerned with larger radiation Copper64). Had 2 high Pancreastatin tests in Feb and March at 660 and 655 with BioAgilitix but three subsequent from Interscience were in 60s. Had anyone else had issues with BioAgilitix lab. Newest is L buttocks pain (possibly bone). Not sure if I should do the PETCT tests.

Have worsening symptoms for close to 20 years but much progression since Sep 21 with multiple liver hemangiomas and harmatomas, not convinced as they increased in size and number.

Hello again, @margaret12,

I'm wondering what type of specialist you are currently seeing ? What recommendations is your doctor giving you about these results and further diagnostic tests?

Have you considered consulting with a research oriented health care facility? I'm thinking of a university medical school or a p!ace like Mayo Clinic.

I saw oncologist surgeon but regular oncologist disregarded. Other then that just regular GI. Not getting any direction

Are your doctors part of a research oriented health care system? If not, this might be a good place to seek a second opinion.

Remember, @margaret12, it is always a patient's right to get a second opinion.

Hello. Just wanted to share that I did have liver mets that they thought were hemangiomas until I had the copper 64 scan. They (2 of them)were first noticed and labeled as hemangiomas in 2015 when I had scans for gallbladder trouble. They did not light up with the gallium 68 scan in 2019. My serotonin was rapidly rising so my doctor at the time switched me to the copper scan. They lit up with the copper scan quite vividly along with several lymph nodes they hadn’t seen in my neck. I had a liver resection and ablation for the two tumors and definitely felt better after. On monthly lanreotide injections now.

I appreciate Your response. Did You have the Copper64 the same year or later on? How did You feel with the Copper64 test?

Were they originally found on MRI? Were the sizes over 1com or below?
Thank You,

Sorry. Had to go back and read my medical records. The first one was found by ultrasound in 2016 and was below a cm. An ER visit for a bowel blockage (was actually the NET in the terminal ileum) and CT scan in Jan of 2019 saw the second “hemangioma”. I had a follow up gallium CT PET scan in July of 2021. Everything looked fine but my serotonin was rapidly rising so my doctor ordered a copper scan in August of 2021. That’s when the tumors lit up. Oddly, the tumors got up to 2.4 cm then shrunk down to 1.9cm before the surgery. Going to say the copper scan was pretty uncomfortable for a few minutes. I had the strongest flushing episode ever when they were injecting me. With
the gallium scan I had a feeling of “I don’t feel good” but it was minor. I’m grateful that I was able to get the copper scan as
it seemed much more sensitive to my tumors and would do it again.

I wish the very best for
you and hope all turns out well.