title: Primary hepatic neuroendocrine tumor with multiple liver metastases: A case report with review of the literature.
abstract: We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago. Follow-up ultrasound examination revealed that the masses had significantly increased; the largest was located in the right lobe (about 8.2 cm × 7.4 cm × 6.0 cm). Abdominal multidetector computed tomography revealed multiple well-circumscribed, heterogeneous, hypodense masses (largest, 6.4 cm × 6.3 cm × 5.0 cm) with significant contrast enhancement during the arterial and portal phases and with contrast wash-out and peripheral enhancement during the delayed phases. Magnetic resonance images demonstrated multiple well-circumscribed, heterogeneous, hypointense hepatic masses with significant contrast enhancement (largest, 6.4 cm × 6.5 cm × 5.1 cm); multiple enlarged porta lymph nodes; and multiple slightly enlarged retroperitoneal lymph nodes. Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type (grade 2 well-differentiated neuroendocrine carcinoma). After performing a systemic examination to exclude metastasis from an extrahepatic primary site, we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases. The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin (150 mg) mixed with one bottle of gelatin sponge particles (560-710 μm) and lipiodol (6 mL). Primary neuroendocrine tumors of the liver are extremely rare. This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas. Previously reported cases in the literature are also reviewed.
authors.affiliation: Kai Yang, Ying-Sheng Cheng, Department of Radiology and Medical Imaging, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 201306, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yang
authors.affiliation: Kai Yang, Ying-Sheng Cheng, Department of Radiology and Medical Imaging, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 201306, China.
authors.forename: Ying-Sheng
authors.initials: YS
authors.lastname: Cheng
authors.affiliation: Kai Yang, Ying-Sheng Cheng, Department of Radiology and Medical Imaging, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 201306, China.
authors.forename: Ji-Jin
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Kai Yang, Ying-Sheng Cheng, Department of Radiology and Medical Imaging, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 201306, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Kai Yang, Ying-Sheng Cheng, Department of Radiology and Medical Imaging, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 201306, China.
authors.forename: Ji-Xiang
authors.initials: JX
authors.lastname: Guo
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D016461:Chemoembolization, Therapeutic; D003951:Diagnostic Errors; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D005780:Gelatin / Q000008:administration & dosage; D006391:Hemangioma / Q000175:diagnosis; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000556:secondary* / Q000628:therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011237:Predictive Value of Tests; D047368:Tumor Burden
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D004998:Ethiodized Oil; D005780:Gelatin
keywords: Imaging; Immunohistochemical; Liver; Metastatic; Neoplasms - primary; Neuroendocrine tumor; Transcatheter arterial chemoembolization