PDF(Pubmed)
Abstract：
Neuroendocrine tumors (NETs) of the gastrointestinal tract (GIT) are rare malignancies, which may have unique presentations. The diagnostic process predominantly relies on immunohistochemical analysis. While tumor markers are extensively utilized in diagnosing and monitoring GI malignancies, their specific role in NETs has not been fully explored. This case describes an 83-year-old male presenting with jaundice and general weakness. Diagnostic imaging through MRI and CT angiography (CTA) revealed a nodular texture on the liver\'s surface suggesting cirrhosis. The presence of elevated tumor markers, specifically carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA 19-9), raised suspicions of malignancy. A subsequent liver biopsy confirmed the diagnosis of small-cell high-grade neuroendocrine carcinoma accompanied by reactive fibrosis. As per our knowledge, this case is the first recorded instance of a liver neuroendocrine tumor (NET) exhibiting elevated levels of both CEA and CA 19-9, with no abnormalities detected in the gallbladder, biliary tree, and bowel in the MRI with magnetic resonance cholangiopancreatography (MRCP) and CTA. This is an atypical presentation of a liver NET, mimicking cirrhotic liver morphology, and underscores the potential diagnostic relevance of tumor markers CEA and CA 19-9 in such cases.
摘要：
胃肠道（GIT）的神经内分泌肿瘤（NETs）是罕见的恶性肿瘤，可能有独特的演示文稿。诊断过程主要依赖于免疫组织化学分析。虽然肿瘤标志物广泛用于诊断和监测胃肠道恶性肿瘤，它们在网络信息技术中的具体作用尚未得到充分探索。该病例描述了一名83岁的男性，表现为黄疸和全身无力。通过MRI和CT血管造影（CTA）进行的诊断成像显示肝脏表面有结节状纹理，提示肝硬化。升高的肿瘤标志物的存在，特别是癌胚抗原（CEA）和癌症抗原19-9（CA19-9），引起了对恶性肿瘤的怀疑.随后的肝活检证实了伴有反应性纤维化的小细胞高级神经内分泌癌的诊断。根据我们的知识,该病例是首次记录的肝神经内分泌肿瘤（NET），表现出CEA和CA19-9水平升高，胆囊中未检测到异常，胆道树,磁共振胰胆管造影（MRCP）和CTA的MRI和肠。这是肝脏网的非典型表现，模仿肝硬化肝脏形态，并强调了肿瘤标志物CEA和CA19-9在这种情况下的潜在诊断相关性。
