Hepatic resection and transplantation for primary carcinoid tumors of the liver.
OBJECTIVE
To discuss the diagnosis and management of primary carcinoid tumors of the liver in light of our experience and a literature review.


BACKGROUND
Carcinoid tumors of the liver are rare and pose a diagnostic and management dilemma. This series is the largest reported and the only one to include liver transplantation as a treatment option.


METHODS
Between March 1994 and May 2002, we treated 8 patients (4 male, 4 female) with primary hepatic carcinoid tumors. Carcinoid syndrome complicated only 1 of the cases. Treatment was by liver resection in 6 patients and orthotopic liver transplantation in 2.


RESULTS
The diagnosis was confirmed histologically with light microscopy and immunohistochemistry in the absence of an alternative primary site. Six patients remain alive and disease free after follow-up of more than 3 years: 39, 43, 45, 50, 50, and 95 months. Two patients are recently postoperative.


CONCLUSIONS
Active exclusion of an extrahepatic primary site is essential for the diagnosis of primary carcinoid of the liver. The mainstay of treatment should be liver resection, although liver transplantation may be considered in patients with widespread hepatic involvement. A radical surgical approach is warranted as this disease carries a better prognosis than for other primary hepatic tumors and for secondary hepatic carcinoids.
Fenwick
Stephen W
SW
Hepatobiliary and Transplant Unit, St James's University Hospital, Leeds, UK.
Wyatt
Judith I
JI
Toogood
Giles J
GJ
Lodge
J Peter A
JP
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged