• Hepatitis B virus
• Hepatocellular carcinoma
• Primary hepatic neuroendocrine tumor
• Transcatheter arterial chemoembolization

• Case report
• Hepatic resection
• Liver primary neuroendocrine tumor

Primary hepatic neuroendocrine tumors (PHNETs) are an utterly rare subtype of neuroendocrine tumors (NETs) that arise from cells of the neuroendocrine system. Due to the rarity and lack of distinctive radiological features, diagnosis and management of this tumor are challenging. Herein, we report a case of PHNET in a 19-year-old previously healthy female patient whose diagnosis was confirmed by histopathology and immunohistochemistry. This case emphasizes the importance of considering PHNETs in the differential diagnosis of a hepatic mass, management of patients with this disease, and post-operative follow-up.

Effective treatment options for nonresectable hepatic carcinoma (HC) in dogs are limited.

Objectives were to report outcomes, complications, and tumor responses via computed tomography (CT) assessment after drug‐eluting bead transarterial chemoembolization (DEB‐TACE) for nonresectable HC in dogs. The authors hypothesized that major complications would be uncommon and short‐term CT assessment would demonstrate stable disease or partial response.

Client‐owned dogs (n = 16) with nonresectable HC.

Prospective, single‐arm clinical trial. Drug‐eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis. Computed tomography imaging was compared before and approximately 12 weeks after initial treatment.

Drug‐eluting bead transarterial chemoembolization was successfully administered in all attempts. Based on percent change in elliptical tumor volume response (mL), stable disease (8/13; 62%) was the most common outcome followed by partial response (3/13; 23%) and progressive disease (2/13; 15%) with a median of 74 days (range, 39‐125) after initial treatment. Median tumor volume (mL) after DEB‐TACE decreased in volume by 13% (range, 56% decrease to 77% increase). Mild complications consistent with postembolization syndrome occurred after 7/27 (26%) treatments. Major complications occurred after 3/27 (11%) treatments: hepatic abscess/septicemia (2) and cholecystitis/death (1), resulting in treatment‐induced death after 2/27 (7%) treatments. Median survival time after treatment was 337 days (range, 22‐1061). Dogs with a presenting complaint of weight loss (P = .02) had a significantly shorter median survival time (126 days; range, 46‐337) than those dogs without prior history of weight loss (582 days; range, 22‐1061).

Drug‐eluting bead transarterial chemoembolization for nonresectable HC is a feasible procedure, which promoted stable disease or partial response in 85% of dogs in this study sample.

• DEB
• TACE
• doxorubicin
• interventional radiology
• liver

We report an unusual presentation of primary hepatic neuroendocrine tumor which was initially misdiagnosed as intrahepatic cholangiocarcinoma. The diagnosis was only revealed after a major liver resection by histopathology. With adjuvant lanreotide injection, the patient survived for more than 16 months after the operation without tumor recurrence. Diagnosis of this rare tumor has been a major challenge and we emphasize the importance of a preoperative diagnosis. Surgical resection remains the mainstay for curative treatment, while peptide receptor radionuclide therapy is an emerging treatment option which has provided promising results.

• Carcinoid tumor
• Liver neoplasm
• Primary hepatic neuroendocrine tumor

• carcinogenesis
• hemangioma
• hepatic cancer
• surgical oncology

• Computed tomography
• Digital subtraction angiography
• Liver carcinoma
• Magnetic resonance imaging
• Neuroendocrine carcinoma

• Adult
• Aged
• Angiography, Digital Subtraction/methods
• Female
• Humans
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/pathology
• Magnetic Resonance Imaging/methods
• Male
• Middle Aged
• Multimodal Imaging/methods
• Neuroendocrine Tumors/diagnostic imaging
• Neuroendocrine Tumors/pathology
• Retrospective Studies
• Tomography, X-Ray Computed/methods

• shanghai municipal commission of health and family planning

• Hepatic lesion
• neuroendocrine
• solitary tumor

• 68Ga-DOTATOC
• Combined tumor
• Hepatocellular carcinoma
• Neuroendocrine carcinoma

• Aged
• Carcinoma, Hepatocellular/diagnostic imaging
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/surgery
• Carcinoma, Neuroendocrine/diagnostic imaging
• Carcinoma, Neuroendocrine/pathology
• Carcinoma, Neuroendocrine/surgery
• Hepatectomy/methods
• Humans
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Magnetic Resonance Imaging
• Male
• Neoplasms, Multiple Primary/diagnostic imaging
• Neoplasms, Multiple Primary/pathology
• Neoplasms, Multiple Primary/surgery
• Positron Emission Tomography Computed Tomography
• Tomography, X-Ray Computed

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.

• Liver
• Neoplasms - primary
• Neuroendocrine tumor
• Metastatic
• Immunohistochemical
• Imaging
• Transcatheter arterial chemoembolization

• Adult
• Antineoplastic Agents/administration & dosage
• Biomarkers, Tumor/analysis
• Biopsy
• Chemoembolization, Therapeutic
• Diagnostic Errors
• Ethiodized Oil/administration & dosage
• Female
• Gelatin/administration & dosage
• Hemangioma/diagnosis
• Humans
• Immunohistochemistry
• Liver Neoplasms/chemistry
• Liver Neoplasms/pathology
• Liver Neoplasms/therapy
• Lymphatic Metastasis
• Magnetic Resonance Imaging
• Multidetector Computed Tomography
• Neuroendocrine Tumors/chemistry
• Neuroendocrine Tumors/secondary
• Neuroendocrine Tumors/therapy
• Organoplatinum Compounds/administration & dosage
• Oxaliplatin
• Predictive Value of Tests
• Tumor Burden

Nous rapportons le cas exceptionnel d'une patiente de 54 ans prise en charge pour une angiocholite due à un thrombus tumoral, d'une tumeur neuroendocrine primitive (TNE I^ve) du foie, dans la voie biliaire principale.

• cholangitis
• liver
• neuroendocrine tumor

Carcinoid tumors are slow-growing tumors originating in the neuroendocrine cells, and occur most frequently within the gastrointestinal tract. Although the liver is the most common site for metastatic carcinoid tumors, primary hepatic carcinoid tumors are exceedingly rare and reports of the imaging findings have been very scarce. We herein report imaging findings with an emphasis on magnetic resonance imaging in two cases of primary hepatic carcinoid tumors. In both cases, the tumors showed cystic areas with hemorrhagic components and early enhanced solid areas.

• Carcinoid
• Liver
• Magnetic resonance imaging

The present study aimed to analyze the imaging features and pathological basis of primary hepatic neuroendocrine carcinoma (PHNEC). A retrospective analysis of the imaging and pathological features of nine PHNEC cases was carried out at The Second Xiangya Hospital of Central South University (Changsha, China). The nine patients were subjected to dynamic contrast-enhanced computed tomography (CT) scanning of the liver and pathological diagnosis of the tissue samples. In addition, two patients were subjected to magnetic resonance imaging (MRI). CT scanning revealed the presence of single or multiple masses in the liver with a maximum diameter of 1–10 cm. These hepatic masses were of low density as showed by plain CT. These masses showed uneven or annular enhancement at their margins in the arterial phase. The venous portal phase showed consistent or declined enhancement and the delayed phase showed light enhancement in these masses. In addition, multiple intrahepatic nodules with long T1 and T2 signal intensities and obvious enhancement were observed by MRI in one patient, while intrahepatic lesions with moderate length T2 signal intensities and light enhancement not visible on the T1 image were observed in another patient. Pathological analysis revealed that the tumor cells exhibited morphological diversity. Immunohistochemical staining revealed that the tumor cells were chromogranin A- and synaptophysin-positive, and carcinoembryonic antigen-, hepatocytic antigen- and α-fetoprotein-negative. Imaging methods, including CT and MRI, are useful for the diagnosis of PHNEC; however, pathological examination is required for a final, definite diagnosis.

• computed tomography
• magnetic resonance imaging
• pathology
• primary hepatic neuroendocrine carcinoma

AIM: To investigate the pathological classification, clinicopathological characteristics and prognosis of hepatic neuroendocrine tumors.

METHODS: Thirty-four cases of hepatic neuroendocrine tumors were divided into an primary disease group and a metastatic disease group. Hepatic neuroendocrine tumors were studied by immunohistochemistry and electron microscopy, and their clinicopathological characteristics were analyzed.

RESULTS: Hepatic neuroendocrine tumors could be divided into three groups: neuroendocrine tumor (G1), neuroendocrine tumor (G2) and neuroendocrine carcinoma (G3). There were 1 case of neuroendocrine tumor (G1), 1 case of neuroendocrine tumor (G2) and 2 cases of neuroendocrine carcinoma (G3) in the primary disease group, and the corresponding figures in the metastatic disease group were 3, 15 and 12, respectively.

CONCLUSION: Primary hepatic neuroendocrine tumors are very rare. The diagnosis of primary hepatic neuroendocrine tumors must eliminate the possibility of metastatic hepatic neuroendocrine tumors. Surgery is an effective treatment modality for hepatic neuroendocrine tumors.

• Hepatic tumors
• Neuroendocrine tumors
• Immunohistochemistry

We present a case of a 71-year-old man with prostate cancer who had no prior underlying liver disease. During metastatic evaluation, a solid mass in the liver was identified by computed tomography and ultrasound. Gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging demonstrated a well-defined, peripheral enhancing hepatic mass containing small cystic component. This lesion was diagnosed as hepatic neuroendocrine tumor. Primary neuroendocrine tumors of the liver are extremely rare. This case is interesting because of the rarity of this neoplasm and the unique radiologic findings despite its small size. Reviews of previously reported cases in the literature are also presented.

• Liver
• contrast agents – intravenous
• magnetic resonance imaging (MRI)
• neoplasms – primary

Primary hepatic carcinoid tumor is rare and poses a challenge for diagnosis and management. We presented a case of primary hepatic carcinoid tumor in a 53-year-old female with a complaint of right upper abdominal pain. Computer tomography scans revealed a hypervascular mass in segment 4 of the liver. An ultrasonography-guided biopsy showed a carcinoid tumor. No other lesions were found by the radiological investigations. Surgery resection was performed and histopathological examination revealed a primary hepatic carcinoid tumor. Three years later, recurrence was found and transcatheter arterial chemoembolization was performed. After transcatheter arterial chemoembolization, the patient has been free of symptom and had no radiological disease progression for over 6 months. Surgical resection combination with transcatheter arterial chemoembolization is effective to offer excellent palliation.

Primary hepatic neuroendocrine tumors (PHNETs) are rear neoplasm. Diagnosis is an evolution, and requires a systematic clinical exclusion with histological confirmation. Treatment is surgical with excellent prognosis, and a long-term follow-up is required due to high tumor recurring rate. Knowledge from this species of tumor remains limited due to paucity of cases. This article elaborates the key features, diagnosis algorithm, current management, other treatment options and extensive review of literature on this rear tumor.

• Carcinoid
• Liver
• Neuroendocrine tumor
• Primary hepatic tumor

Carcinoids are neuroendocrine tumours which may secrete hormones like gastrin, insulin, ACTH, etc. Liver is a common site for metastasis of carcinoid origin and an unusual site for a primary carcinoid tumour to arise.

We present the case of a 51-year-old Caucasian man with diarrhoea, weight loss, duodenum ulcers and a liver mass in ultrasonography. A primary hepatic carcinoid tumour with a Zollinger Ellison syndrome was diagnosed. Surgery resection was performed and the patient remained free of symptoms two years after, with normalisation of gastrin levels.

Primary hepatic carcinoid tumour represents an uncommon diagnosis, based on radiological and pathological features. The exclusion of different primary locations is necessary. Once associated with a Zollinger Ellison syndrome, diagnose may be more complicated and challenging since only 7 cases of hepatic carcinoids with gastrin secretion were reported in medical literature.

A review of medical literature is performed and diagnoses tools that should be used for an accurate diagnosis and available treatment approaches are commented here.