Primary hepatic neuroendocrine carcinoma: clinical analysis of 11 cases.
BACKGROUND
Primary hepatic neuroendocrine carcinoma (PHNEC) is extremely rare, and fewer than 300 cases have been reported in the English/Chinese-language literature, therefore it is difficult to make a proper diagnosis and determine a therapeutic approach.


METHODS
Eleven PHNEC patients were admitted to our hospital between January 1996 and May 2008. Laboratory examination, digestive endoscopy, B-ultrasonography, CT, MRI, or PET-CT were performed on the patients for preoperative diagnosis. All patients received liver resection. Some patients received transcatheter arterial chemoembolization (TACE), percutaneous ethanol injection treatment (PEIT), or octreotide injection when a recurrence was found. The patients' clinical data were recorded and all patients were followed up.


RESULTS
The patients were confirmed pathologically as having PHNEC . Their median follow-up time was 33 months (12-107 months). All patients survived, and the longest post-operative survival time was 107 months, the longest disease-free survival time was 98 months, the 1-year survival rate was 100%, and the 1-year recurrence rate was 45.5% (5/11).


CONCLUSIONS
Since PHNEC is easy to confuse with hepatocellular carcinoma, careful screening of symptoms is needed to avoid misdiagnosis. Resection is the first choice of treatment for PHNEC and provides the most favorable outcomes including long-term survival. Other treatment such as TACE and PEIT can be considered as well, especially when a tumor recurs.
Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Yang-Qing
YQ
Huang
Feng
F
Xu
Jia-Mei
JM
Yang
Bin
B
Huang
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003937:Diagnosis, Differential; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007267:Injections; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000431:Ethanol