An unusual muscular metastasis in a patient affected by ileal carcinoid imaged with a ¹¹¹In-Pentetreotide SPECT/CT scan and confirmed by biopsy.

¹¹¹In-Pentetreotide SPECT/CT scan has been widely validated in diagnosis and follow-up of carcinoid and other neuroendocrine tumors. A 70-year-old man, who underwent an ileal resection for carcinoid 5 years ago, came to our observation during follow-up. We performed a In-DTPA-Pentetreotide (150 MBq) SPECT/CT scan. Images taken after 2 hours showed a focal, pathologic uptake on the left leg, confirmed at later acquisitions. Lateral projection showed that the uptake area was located in a leg muscle; the lesion was confirmed as an intramuscular metastasis by biopsy. Intramuscular metastasis of carcinoid tumors is an extremely rare manifestation, particularly if not adjacent to the primary tumor, because the muscle is a very uncommon location of hematogenous metastases.