title: Primary hepatic carcinoid tumor: a case report and review of the literature.
abstract: BACKGROUND
  Primary hepatic carcinoid tumor (PHCT) is very rare and difficult to diagnose before biopsy or operation. We report a patient with a small PHCT and review cases in the literature.
  
  
  METHODS
  A 48-year-old Chinese female with underlying hepatitis B virus (HBV) infection was found to have a low echoic hepatic nodule by abdominal ultrasound. Tumor markers were negative. Dynamic liver computed tomography scans showed enhancement of the nodule in the arterial phase and early washout in the portal phase. Hepatocellular carcinoma (HCC) was considered based on the image findings and underlying HBV infection. However, the tumor biopsy revealed a malignant neoplasm that originating from neuroendocrine cells. Pre-operative and intra-operative investigations for the possible other origin of carcinoid tumor were negative, so PHCT was confirmed.
  
  
  CONCLUSIONS
  A small and asymptomatic PHCT is extremely rare. PHCT should be one of the differential diagnoses in patients with small hepatic tumor, even in regions with high prevalence of HBV infection and HCC. Pre-operative biopsy is necessary to avoid misdiagnosis even when HCC is highly suspected clinically.
authors.affiliation: Department of Surgery and Organ Transplantation Center, E-Da Hospital/I-Shou University, 1, E-Da Road, Jiau-shu Tsuen, Yan-chau Shiang, Kaohsiung county 82445, Taiwan. yawsen.chen@msa.hinet.net.
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Lin
authors.forename: Chung-Hsu
authors.initials: CH
authors.lastname: Lai
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Hsu
authors.forename: Chao-Tien
authors.initials: CT
authors.lastname: Hsu
authors.forename: Pei-Min
authors.initials: PM
authors.lastname: Hsieh
authors.forename: Kuo-Chen
authors.initials: KC
authors.lastname: Hung
authors.forename: Yaw-Sen
authors.initials: YS
authors.lastname: Chen