Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 5 3 2020 11 24 67 71 Mahsa Abbaszadeh Department of General Internal Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Faeze Salahshour Department of Radiology, Imam Khomeini Hospital Complex, School of Medicine,Tehran University of Medical Sciences, Tehran, Iran. Sahar Karimpour Reyhan -Department of General Internal Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Nasim Khajavi Rad Department of General Internal Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2019 09 10 2020 02 20 Pancreatic Neuroendocrine Tumors (NETs) are a group of tumors that are rare with guiding features on CT scans and MRI images. We report a 38-year-old man referring to our hospital with a history of approximately 20 kg weight loss, fever, and night sweating since 2 months ago. He did not mention any other significant complaint except for generalized pain. Lab data revealed mild anemia and an elevated level of lactate dehydrogenase and alanine aminotransferase. Abdominopelvic sonography showed multiple hypoechoic lesions in the liver in favor of metastasis. Upper gastrointestinal endoscopy and colonoscopy were normal. Abdominopelvic CT scan revealed multiple faint arterial hyperenhancing lesions with welldefined borders in all liver segments suggestive of hypervascular metastasis. Suspicious mass lesion near the posterior border of the pancreatic tail was also seen, suggestive of a pancreatic neuroendocrine tumor as the primary source of hypervascular metastatic lesions. The pathology and immunohistochemistry of the liver mass confirmed the diagnosis of NET. After staging evaluation, he was referred to an oncologist for chemotherapy. https://crcp.tums.ac.ir/index.php/crcp/article/view/302 https://crcp.tums.ac.ir/index.php/crcp/article/download/302/357