Massive hepatomegaly in 99mTc-octreotide scintigraphy: The value of 99mTc-sulfur colloid scan

99mTc-octreotide scintigraphy, performed during the following up a 58-year old man with neuroendocrine tumor demonstrated massive hepatomegaly demonstrating multiple areas of increased and decreased uptake. Due to severe hepatomegaly concurrence of any other abdominal soft tissue lesions could not be excluded. A 99mTc-sulfur colloid scan was done and thoroughly compared with 99mTc-octreotide scintigraphy showing mismatched lesions compatible with liver metastases. Our case demonstrates the importance of multimodality imaging and highlights the forgotten role of 99mTc-Sulfur colloid liver and spleen scan as useful supplementary technique especially when SPECT/CT is not available.