Abstract: A 57-year-old man was referred for an fluoro-deoxy-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT) study of a primary tumor after a poorly differentiated carcinoma with neuroendocrine features which was biopsied from the liver. A 4-phase abdominal CT showed a large liver right lobe mass, suspicious for hypovascular hepatocellular carcinoma. Esophagogastroduodenoscopy and endoscopic ultrasound showed normal findings. Colonoscopy revealed a benign sigmoid colon polyp. PET/CT showed FDG avid bilateral hepatic lobe lesions, disseminated bone lesions, and an intense focus in the prostate suspicious for a prostatic primary. However, PSA was within the normal range. Tissue sampling of the prostatic lesion revealed small cell carcinoma with neuroendocrine features.