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Operated for a carsinoid cancer in rectum. Have hemangiom in seg5 in liver. Is it metastase?

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I'm just recently operated for a carsinoid cancer in rectum. It was 7 mm, and had a slow growth. After half a year I had a follow up, with kolonscopi and gastroscopi. No problems there. On the octeotidscintigrafi there was a suspecious lesion in my liver, segment 5. I also have a hemangiom in seg5 in my liver, found on ct in May this year. Can this hemangion give the same reaction on the scintigrafi or is it metastase? (They explained the scintigraphy to show how my body "eats" sugar. All my blood samples were very good. What can I expect concering treatment if it is a metastase?
Thanks :).
Posted Tue, 27 Nov 2012 in Cancer
Answered by Dr. Indranil Ghosh 9 hours later

Thanks for writing in.

You had a 7 mm carcinoid with Ki 67 < 1% (very low grade and small size). It is very unlikely to throw up a liver metastasis. Though hemangioma should not pick up uptake on ocetrotide scintigraphy, I would consider mets a low possibility.

At this stage you should have a triphasic CT scan abdomen to delineate the type and size of the lesion. If still doubt remains then fine needle aspiration may be needed.

Even if it is a metastasis, as it is solitary it can be removed surgically and long-term survival can be still expected.

Hope I have answered your query. I willl be available for further follow-up queries, if any.
Above answer was peer-reviewed by
Follow-up: Operated for a carsinoid cancer in rectum. Have hemangiom in seg5 in liver. Is it metastase? 3 hours later
Thank you for the answer.
I live in Norway, and go to the university hospital of northern Norway (UNN). Maybe prosedures differs a bit. I have had an MR. Will that be the same/ as good as the triphasic CD scan? The doctor also told me that any inflammation in the liver would show. But what inflammation is possible to get in the liver, -except hepatitt and mononucleosis (based upon the internet)? What else can pick up on ocetotride scintigraphy?
About the ocetotride scintigraphy: does it show malfunction in cells in an early stage, like before a tumor would show on ct or mr? Or is it a tiny tumor already if it shows on the ocetotride scintigrafi?

I've had a resurgery a week ago because they had too little tissue on one spot (6 mm instead of 10mm) on the operation in May. So in a way they operated my scare and made me a new one. After the first operation they did not find any cancer outside the tumor itself. When they have the final results from this operation and adding the results from the MR they will come up with a plan. Is it possible for some cancer cells to let go from the tumor, for instanse during operation, settle down in my liver and stsrt a new colony? ( is this how metastase occurs?).

Thanks again:).
Answered by Dr. Indranil Ghosh 7 hours later
My answers to your queries...
1. Focal liver infection like granuloma may show up. most of the time these are benign. MRI is also a good modality to detect these.
octreoscan will show tumors only, not just cell dysfunction
2.the mechanism of mets is like that what you mentioned but as I said you are very unlikely to have mets. But operation does not lead to spread of tumor.

Above answer was peer-reviewed by
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