Diagnosis of primary hepatic carcinoid tumor: report of one case

Primary hepatic neuroendocrine tumors: clinical characteristics and imaging features on contrast-enhanced ultrasound and computed tomography

OBJECTIVE

Primary hepatic neuroendocrine tumor (PHNET) is an extremely rare liver neoplasm, and its clinical characteristics and imaging features are not well understood. The aim of this study was to analyze the clinical profiles and imaging features of PHNETs on contrast-enhanced ultrasound (CEUS) and computed tomography (CT) METHODS: Patients with PHNET between January 2008 and December 2015 were retrospectively identified, and their demographics, laboratory data, and imaging characteristics on CEUS and CT analyzed.

RESULTS

Ten consecutive patients with PHNETs were included (including one G1, seven G2, and two G3 of tumor grades).The median age of patient was 45 years (range: 27-72 years), and 60.0% of patients were male. The most common symptom was abdominal pain (60.0%), and cirrhosis was found in 40.0% of patients. Tumors were confined within the liver in 60.0% of patients, while the remaining patients had extra-hepatic metastasis. The tumors revealed hyperechoic in 60% of patients and mixed echoic in 30% of patients on conventional US, displaying intense arterial enhancement followed by washout in the portal and/or the late phases in 80.0% of patients on CEUS and 60% at CT.

CONCLUSIONS

Although PHNET is a very rare liver tumor, it should be considered as a possible differential diagnosis in the management of hepatic tumors. Most PHNETs were hyperechoic or mixed echoic on conventional US, showing similar enhancement patterns to that of hepatocellular carcinoma on CEUS.

Imaging and pathological features of primary hepatic neuroendocrine carcinoma: An analysis of nine cases and review of the literature

The present study aimed to analyze the imaging features and pathological basis of primary hepatic neuroendocrine carcinoma (PHNEC). A retrospective analysis of the imaging and pathological features of nine PHNEC cases was carried out at The Second Xiangya Hospital of Central South University (Changsha, China). The nine patients were subjected to dynamic contrast-enhanced computed tomography (CT) scanning of the liver and pathological diagnosis of the tissue samples. In addition, two patients were subjected to magnetic resonance imaging (MRI). CT scanning revealed the presence of single or multiple masses in the liver with a maximum diameter of 1–10 cm. These hepatic masses were of low density as showed by plain CT. These masses showed uneven or annular enhancement at their margins in the arterial phase. The venous portal phase showed consistent or declined enhancement and the delayed phase showed light enhancement in these masses. In addition, multiple intrahepatic nodules with long T1 and T2 signal intensities and obvious enhancement were observed by MRI in one patient, while intrahepatic lesions with moderate length T2 signal intensities and light enhancement not visible on the T1 image were observed in another patient. Pathological analysis revealed that the tumor cells exhibited morphological diversity. Immunohistochemical staining revealed that the tumor cells were chromogranin A- and synaptophysin-positive, and carcinoembryonic antigen-, hepatocytic antigen- and α-fetoprotein-negative. Imaging methods, including CT and MRI, are useful for the diagnosis of PHNEC; however, pathological examination is required for a final, definite diagnosis.