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Primary hepatic neuroendocrine tumors: A case report
1Department of MRI Room, Qinghai Provincial People's Hospital, Xining, Qinghai Province.
Medicine
|December 20, 2019
Summary
Primary hepatic neuroendocrine tumors (PHNET) are rare and challenging to diagnose. Imaging and pathology are key for identifying these liver tumors, with surgical excision being the primary treatment.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Primary hepatic neuroendocrine tumors (PHNET) are exceptionally rare, leading to limited awareness of their distinct imaging and pathological features among clinicians.
- Accurate diagnosis of PHNET is often hindered without invasive procedures like biopsy or surgical resection.
Observation:
- A 52-year-old male presented with intermittent upper abdominal pain, prompting investigation for liver abnormalities.
- Preoperative biochemical tests were largely unremarkable. MRI revealed characteristic findings: low T1WI, slightly high T2WI/FS, and high DWI signal.
- Postoperative histopathology confirmed the diagnosis through immunohistochemistry, with positive markers for synaptophysin, CD56, and chromogranin A, and a Ki-67 index of 15%.
Findings:
- Immunohistochemistry confirmed PHNET with positive staining for synaptophysin, CD56, and chromogranin A, alongside a Ki-67 proliferation index of 15%.
- Laparoscopic surgical excision using an ultrasound scalpel was successfully performed, followed by supportive care.
- The patient experienced no discomfort and showed no signs of recurrence during a 15-month follow-up period.
Implications:
- Clinicians should consider PHNET in the differential diagnosis of liver tumors presenting as solid masses with clear boundaries, even in the absence of cirrhosis, hepatitis, or elevated alpha-fetoprotein.
- Pathological examination, particularly immunohistochemistry, is crucial for definitive PHNET diagnosis.
- Surgical excision remains the principal therapeutic strategy for primary hepatic neuroendocrine tumors.
