A 62-year-old man presented with pain and gradually increasing swelling of the right scapular region for four months. On examination, there was a bony hard swelling on the scapula with no restriction of movement. Magnetic resonance imaging (MRI) showed a destructive lesion in the spine of the scapula (Figure 1). Whole body 18-Fluoro-deoxy-glucose positron emission tomography (FDG-PET) showed a non-FDG avid lesion in the spine of the scapula, with no other metabolically active lesion identified elsewhere (Figure 2). The spine of the scapula was surgically resected with adequate margins. Histopathology revealed a neuroendocrine tumor (NET). Lesional cells showed diffused string immunopositivity for pan cytokeratin (pan CK) an epithelial cell marker and markers of neuroendocrine differentiation, chromogranin and synaptophysin (Figure 3). Upper and lower endoscopies were negative for a primary gastrointestinal NET. Postoperatively, the patient did not receive any adjuvant therapy. The patient was followed up over four years and has remained disease free, clinically and radiologically.

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