PDF(Pubmed)
Abstract：
UNASSIGNED: Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare, and the clinical symptoms, test results, and imaging characteristics are nonspecific in most patients; thus, it is difficult to differentiate from other liver masses before surgery. Histopathology and immunohistochemistry are the main basis for the diagnosis. PHNETs and colon tumors co-occur in a patient and are non-homologous, as reported in the English-language literature for the first time.
METHODS: We present a case of a 60-year-old woman with right hepatic lobe mass accidentally discovered on abdominal ultrasonography during a routine examination. Preoperative liver contrast-enhanced computed tomography suggested hepatocellular carcinoma; then, surgery were performed. Pathological results revealed a Grade 2 neuroendocrine tumor of the liver. In search of the primary tumor, upper and lower endoscopy of the GI tract was performed and revealed a mass in the ascending colon. Ascending colon cancer was considered; then, laparoscopic right hemicolectomy was performed. Pathological results suggested tubular villous adenoma of the ascending colon. The final diagnosis was not colon cancer with liver metastases but was PHNETs with colon adenoma.
UNASSIGNED: PHNETs are rare cancers that are difficult to diagnose, requiring not only differentiation from other liver masses but also exclusion of metastases from extrahepatic sources. The pathological results play an important in making an accurate diagnosis.
CONCLUSIONS: Pathology, postoperative follow-up, and comprehensive imaging examinations are powerful tools in the diagnosis of PHNETs. Currently, surgery is the best treatment to achieve a potential cure and prolong the patient\'s survival.
METHODS: We present a case of a 60-year-old woman with right hepatic lobe mass accidentally discovered on abdominal ultrasonography during a routine examination. Preoperative liver contrast-enhanced computed tomography suggested hepatocellular carcinoma; then, surgery were performed. Pathological results revealed a Grade 2 neuroendocrine tumor of the liver. In search of the primary tumor, upper and lower endoscopy of the GI tract was performed and revealed a mass in the ascending colon. Ascending colon cancer was considered; then, laparoscopic right hemicolectomy was performed. Pathological results suggested tubular villous adenoma of the ascending colon. The final diagnosis was not colon cancer with liver metastases but was PHNETs with colon adenoma.
UNASSIGNED: PHNETs are rare cancers that are difficult to diagnose, requiring not only differentiation from other liver masses but also exclusion of metastases from extrahepatic sources. The pathological results play an important in making an accurate diagnosis.
CONCLUSIONS: Pathology, postoperative follow-up, and comprehensive imaging examinations are powerful tools in the diagnosis of PHNETs. Currently, surgery is the best treatment to achieve a potential cure and prolong the patient\'s survival.
摘要：
■原发性肝神经内分泌肿瘤（PHNETs）极为罕见，和临床症状，测试结果,大多数患者的影像学特征是非特异性的；因此，手术前很难与其他肝脏肿块区分开来。组织病理学和免疫组化是诊断的主要依据。PHNETs和结肠肿瘤共同出现在患者中，并且是非同源的，这是第一次在英语文献中报道。
方法：我们介绍一例60岁女性，在常规检查中腹部超声检查中意外发现右肝叶肿块。术前肝脏对比增强计算机断层扫描提示肝细胞癌；然后，进行了手术。病理结果提示肝脏2级神经内分泌肿瘤。寻找原发性肿瘤，进行了胃肠道的上下内窥镜检查，发现升结肠有肿块。考虑了上升结肠癌；然后，行腹腔镜右半结肠切除术。病理结果提示升结肠管状绒毛状腺瘤。最终诊断不是结肠癌伴肝转移，而是PHNETs伴结肠腺瘤。
■PHNETs是难以诊断的罕见癌症，不仅需要与其他肝脏肿块区分，还需要排除肝外来源的转移。病理结果在做出准确诊断中起重要作用。
结论：病理学，术后随访,全面的影像学检查是诊断PHNETs的有力工具。目前,手术是实现潜在治愈和延长患者生存期的最佳治疗方法。
方法：我们介绍一例60岁女性，在常规检查中腹部超声检查中意外发现右肝叶肿块。术前肝脏对比增强计算机断层扫描提示肝细胞癌；然后，进行了手术。病理结果提示肝脏2级神经内分泌肿瘤。寻找原发性肿瘤，进行了胃肠道的上下内窥镜检查，发现升结肠有肿块。考虑了上升结肠癌；然后，行腹腔镜右半结肠切除术。病理结果提示升结肠管状绒毛状腺瘤。最终诊断不是结肠癌伴肝转移，而是PHNETs伴结肠腺瘤。
■PHNETs是难以诊断的罕见癌症，不仅需要与其他肝脏肿块区分，还需要排除肝外来源的转移。病理结果在做出准确诊断中起重要作用。
结论：病理学，术后随访,全面的影像学检查是诊断PHNETs的有力工具。目前,手术是实现潜在治愈和延长患者生存期的最佳治疗方法。
