Figure 1.

Preoperative and Postoperative Imaging

(A) Axial computed tomography scan with large (approximately 4.2 × 3.3 cm), heterogeneously enhancing mass (arrow) visualized anterior to the ascending aorta. (B) Axial magnetic resonance imaging with heterogenous late gadolinium uptake (arrow). (C) Intraoperative image showing the gross appearance of the mass (arrow). (D) Postoperative PET-dotatate imaging showing focal uptake (arrow), compatible with residual disease. (E) PET imaging with focal avid uptake in the small bowel (arrow), suspicious for metastatic versus synchronous disease. (F) Nests of cells stained for neuroendocrine markers chromogranin and synaptophysin. PET = positron emission tomography; PET-dotatate = positron emission tomography with 68 Ga dotatate.