Published online Aug 16, 2016. doi: 10.12998/wjcc.v4.i8.243
Peer-review started: February 14, 2016
First decision: March 30, 2016
Revised: April 24, 2016
Accepted: May 17, 2016
Article in press: May 27, 2016
Published online: August 16, 2016
Processing time: 181 Days and 23.2 Hours
Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and difficult to distinguish from other liver tumors, such as hepatocellular carcinoma (HCC) and cholangiocarcinoma, based on medical imaging findings. A 70-year-old man was referred for evaluation of liver mass incidentally discovered on abdominal computed tomography. The characteristic finding from dynamic liver magnetic resonance imaging led to a diagnosis of HCC. The patient underwent right hepatectomy. Histopathological and immunohistochemical examination revealed grade 2 neuroendocrine tumor. The postoperative 24-h urinary excretion of 5-hydroxy-indolacetic acid was within the normal range. Further imaging investigations were performed. No other lesions were found making probable the diagnosis of PHNET. This case shows that the diagnosis of PHNET is a medical challenge, requiring differentiation of PHNETs other hepatic masses and exclusion of occult primary neuroendocrine tumors. The diagnosis of PHNET can be ascertained after long term follow-up to exclude another primary origin.
Core tip: Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and difficult to diagnose before preoperative biopsy or surgery. This case report shows that the diagnosis of PHNET is a medical challenge. Thus differentiation of PHNET from other hepatic mass and exclusion of occult primary neuroendocrine tumors are necessary. The diagnosis of PHNET can be ascertained after long term follow-up to exclude another primary origin.