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Jiong LUO, Jifeng SU, Lin WANG. Diagnosis and Treatment of 11 Cases of Primary Hepatic Neuroendocrine Tumors[J]. Journal of Kunming Medical University.
Citation: Jiong LUO, Jifeng SU, Lin WANG. Diagnosis and Treatment of 11 Cases of Primary Hepatic Neuroendocrine Tumors[J]. Journal of Kunming Medical University.

Diagnosis and Treatment of 11 Cases of Primary Hepatic Neuroendocrine Tumors

  • Received Date: 2023-12-22
    Available Online: 2024-04-29
  •   Objective   To summarize the case data of patients with primary liver neuroendocrine tumors (PHNET) and analyze their clinical characteristics, imaging manifestations, pathological characteristics, and diagnosis and treatment status so as to improve the clinical diagnosis and treatment.   Methods  11 PHNET patients (7 females and 4 males with the age ranged from 24 to 68 and the median age being 65 ) treated in the Second Affiliated Hospital of Kunming Medical University from January 1, 2016 to May 9 were selected and the clinical manifestations, laboratory examinations, imaging features, pathological findings, diagnosis and treatment process, and prognosis were retrospectively analyzed.   Results  Abdominal pain was the main symptom of the patients, including 5 cases of abdominal pain, 1 case of abdominal distension and the remaining 5 cases without obvious clinical symptoms. AFP, CEA and HBsAg were all negative, and CA-199 was elevated in only 2 patients. Contrast-enhanced ultrasound images of 7 cases showed “fast in and fast out” model. 256-slice CT enhanced scan of 6 cases revealed the obvious enhancement in arterial phase and enhancement decline in venous phase and equilibrium phase. Five cases of magnetic resonance imaging (MRI) showed the cluster distribution or large focal area with subfocal area and T1WI sequence showed the low signal in 4 cases and mixed high and low signal in 1 case. T2WI sequence showed the high signal, and diffusion weighted imaging (DWI) displayed marginal interval enhancement of lesion. All patients were NET by histopathological examination, including 2 cases of G1 phase and 9 cases of G2 phase. The positive rates of CgA, Ki-67, CD-56 and Syn were 72.73% (8/11), 100.00% (11/11), 81.82% (9/11) and 100.00% (11/11) respectively. 9 patients underwent the radical hepatectomy, and 2 patients underwent the puncture biopsy without follow-up treatment. During the follow-up period of 6.0-37.0 months, 6 patients survived, 2 patients died, and 3 patients were lost to follow-up. There were 5 cases of postoperative recurrence, including 4 cases treated with transcatheter arterial chemoembolization (TACE) and 1 case treated with TACE+oral targeted drug sulfatinib, and finally 4 cases survived.   Conclusion  PHNET lacks the characteristic clinical manifestations and imaging characteristics and the diagnosis depends on the histopathological examination and the exclusion of other lesions. Early detection and combined treatment are important strategies to improve the prognosis of patients.
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