CT scan of the chest, abdomen and pelvis was performed which revealed an endobronchial lesion in the superior segment of the lingual. Multiple varying size hepatic lesion likely to be metastasis, which was confirmed by biopsy one of the lesion which turn to be a neuroendocrine tumor. Tc-Octeriotide scan was performed which revealed radiotracer uptake in the chest corresponding to the lingular endobronchial lesion and hepatic uptake corresponding to the metastases.

3 months later the patient developed shortness of breath. CTPA was performed to rule out pulmonary embolism. No emboli within the pulmonary arteries were seen however the size of the liver metastases were tremendously increased with elevation of the right hemidiaphragm. The size of the pulmonary carcinoid did not change significantly.