Korean J Gastroenterol.  2022 Jan;79(1):35-40. 10.4166/kjg.2021.139.

Primary Hepatic Neuroendocrine Tumor Arising at a Young Age: Rare Case Report and Literature Review

• Song S
• Koh Y

• KMID: 2525521
• DOI: http://doi.org/10.4166/kjg.2021.139

Abstract

Neuroendocrine tumors (NETs) are low-grade malignancies arising from neuroendocrine cells. Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and difficult to differentiate from other liver tumors, such as hepatocellular carcinoma (HCC) or cholangiocarcinoma. A 22-year-old male presented with intermittent abdominal pain. A preoperative imaging study revealed a 5.1cm-sized heterogeneously enhancing mass in S6 of the liver, suggesting HCC. Laparoscopic right hepatectomy was performed, and a well-demarcated brown solid mass was found. The pathology report revealed a neuroendocrine tumor of the liver. 18F-fluorodeoxyglucose–positron emission tomography/computed tomography was performed postoperatively to exclude extrahepatic lesions, and no lesions were found. This is a rare case of PHNET that developed at a young age and was misdiagnosed as HCC preoperatively. This suggests that PHNET should be considered one of the differential diagnoses when a non-specific enhanced hepatic tumor is found, even when the patient is young.

Keyword

Neuroendocrine tumors; Operative

Figure

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  Fig. 1 (A-C) Abdominal ultrasonography and color Doppler image showed 5.0×4.0 cm mixed echoic mass in right hepatic lobe (arrows of A, B).

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  Fig. 2 (A-C) Abdominal computed tomography showed a 5.1 cm enhancing mass in S6 of the liver in the arterial phase, partial enhancing in the portal phase, and a washout pattern in the delayed phase (arrow in A, arterial phase; B, portal phase; C, delayed phase).

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  Fig. 3 (A) Abdominal magnetic resonance imaging showed the lesion demonstrating peripheral enhancement on the arterial phase (arrow), (B) contrast washout with peripheral rim enhancement on the portal (arrow), (C) 20-min delayed phase (arrow), and (D) cystic component (T2WI; arrow).

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  Fig. 4 (A, B) Surgical specimen of the liver revealed a 6.6×4.2 cm yellow-to-brown solid mass in S6 (arrows).

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  Fig. 5 Microscopy findings of the liver mass showed (A) a well-demarcated tumor (hematoxylin and eosin stain [H&E], ×20), and (B) diffuse and cord-like growth pattern of tumor cells (H&E, ×40), and (C) uniform round to ovoid tumor cells (H&E, ×100), and (D) in immunohistochemical staining, the tumor cells were positive for chromogranin (×20).

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