title: Primary hepatic neuroendocrine tumour requiring live donor liver transplantation: case report and concise review.
abstract: Primary hepatic neuroendocrine tumours are rare tumours effecting relatively young patients. As metastatic neuroendocrine tumours to the liver are much more common, extensive investigations are crucial to exclude a primary tumour elsewhere. We report a case of a 27 year old woman who presented with fatigue, increased abdominal girth and feeling of early satiety and bloating. Extensive work up failed to show tumour at another primary site. Hepatic artery embolization showed no effect, so the patient underwent total hepatectomy and live-donor liver transplant. Grossly the tumour measured 27 cm. Microscopic examination showed bland, monomorphic cells growing in tubuloglandular and trabecular growth patterns. Cells were positive for neuroendocrine (synaptophysin, chromogranin, CD56) and epithelial markers (MOC31, CK7, CK19). Cytoplasmic dense neurosecretory vesicles were seen on ultrastructural examination. Based on the Ki-67 rate, mitotic count, lack of marked nuclear atypia and absence of necrosis, a diagnosis of primary neuroendocrine grade 2 was conferred.
authors.affiliation: Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Canada. ananta@interchange.ubc.ca
authors.forename: Ananta
authors.initials: A
authors.lastname: Gurung
authors.forename: Eric M
authors.initials: EM
authors.lastname: Yoshida
authors.forename: Charles H
authors.initials: CH
authors.lastname: Scudamore
authors.forename: Almoutaz
authors.initials: A
authors.lastname: Hashim
authors.forename: Siegfried R
authors.initials: SR
authors.lastname: Erb
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Webber
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure; D016031:Liver Transplantation; D019520:Living Donors; D008854:Microscopy, Electron; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor