Diagnosis and Treatment of 11 Cases of Primary Hepatic Neuroendocrine Tumors

Jiong LUO; Jifeng SU; Lin WANG

doi:10.12259/j.issn.2095-610X.S20241128

Volume 45 Issue 11

Nov. 2024

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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, 2024, 45(11): 103-109. doi: 10.12259/j.issn.2095-610X.S20241128

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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, 2024, 45(11): 103-109. doi: 10.12259/j.issn.2095-610X.S20241128

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Diagnosis and Treatment of 11 Cases of Primary Hepatic Neuroendocrine Tumors

doi: 10.12259/j.issn.2095-610X.S20241128

Ward 2，Dept. of Hepatobiliary and Pancreatic Surgery，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2023-12-22
Available Online: 2024-04-29
Publish Date: 2024-11-25

Abstract

Abstract

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.
- Primary hepatic neuroendocrine tumors,
- Hepatic tumor,
- Diagnosis,
- Treatment

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References(28)

References

[1]	张奔龙,鲁意迅,李力,等. 基于单中心490例胃神经内分泌肿瘤建立的列线图具有良好的预后预测性能[J]. 南方医科大学学报,2023,43(2):183-190. doi: 10.12122/j.issn.1673-4254.2023.02.04
[2]	Elayan A,Batah H,Badawi M,et al. Primary hepatic neuroendocrine tumor: A case report and literature review[J]. Cureus,2022,14(2):e22370.
[3]	Yu W M,Li R,Sun B L,et al. Primary hepatic neuroendocrine tumour with multiple liver metastases: A case report with literature review[J]. International Journal of Surgery Case Reports,2021,89(1):106590.
[4]	中国抗癌协会神经内分泌肿瘤委员会. 中国胃肠胰腺神经内分泌肿瘤专家共识(2016版)[J]. 临床肿瘤学杂志,2016,21(10):927-946.
[5]	Bouzayan L,Madani A,Malki S,et al. Primary hepatic origin of a neuroendocrine tumor: A rare case report[J]. Ann Med Surg (Lond),2022,84(1):104937.
[6]	Kaneko R,Kimura Y,Sakata H,et al. A case of primary hepatic mixed neuroendocrine-non-neuroendocrine tumor (MiNEN) associated with gallbladder carcinosarcoma[J]. Clin J Gastroenterol,2020,13(6):1280-1288. doi: 10.1007/s12328-020-01202-8
[7]	Wong P C,She W H,Khoo U S,et al. A case of primary hepatic neuroendocrine tumor and literature review[J]. Case Reports in Oncology,2021,14(1):90-97. doi: 10.1159/000510935
[8]	张力夫,姚小晓,王禹,等. 原发性肝脏神经内分泌肿瘤的诊断与治疗[J]. 中华消化外科杂志,2019,18(7):698-700. doi: 10.3760/cma.j.issn.1673-9752.2019.07.015
[9]	Shi C,Jug R,Bean S M,et al. Primary hepatic neoplasms arising in cirrhotic livers can have a variable spectrum of neuroendocrine differentiation[J]. Hum Pathol,2021,116(1):63-72.
[10]	冯伟,周梦豪,张坦,等. 原发性肝脏神经内分泌肿瘤21例临床特征和预后影响因素分析[J]. 中华肝胆外科杂志,2020,26(1):19-21. doi: 10.3760/cma.j.issn.1007-8118.2020.01.005
[11]	王文清. 肝脏原发性和转移性神经内分泌肿瘤的超声造影表现对比[J]. 肝脏,2020,25(5):498-500. doi: 10.3969/j.issn.1008-1704.2020.05.017
[12]	周元龙,李思柔,郭岩松,等. 1例原发性肝脏神经内分泌肿瘤的诊断[J]. 山东医药,2023,63(3):81-83. doi: 10.3969/j.issn.1002-266X.2023.03.019
[13]	袁丹丹,刘静,曹笑婉,等. 肝脏原发性神经内分泌肿瘤三期增强扫描CT特征[J]. 临床放射学杂志,2020,39(12):2462-2465.
[14]	Han Y,Li L,Sun H. Computed tomography and magnetic resonance imaging in the diagnosis of primary neuroendocrine tumors of the liver[J]. World Neurosurg,2020,138(1):723-731.
[15]	史东立,马良,李宏军. 原发肝脏神经内分泌肿瘤的临床及影像特征[J]. 磁共振成像,2020,11(8):655-658. doi: 10.12015/issn.1674-8034.2020.08.012
[16]	何莎莎,王青乐,周旭峰. 肝原发性神经内分泌肿瘤MRI分析[J]. 医学影像学杂志,2021,31(5):818-821.
[17]	Bai X,Zhang X,Wang X. Primary hepatic neuroendocrine tumor: pretherapy and post-therapy FDG PET/CT finding[J]. Clin Nucl Med,2019,44(1):88-90. doi: 10.1097/RLU.0000000000002376
[18]	Zhang Z,Li H. Surgical treatment of primary hepatic neuroendocrine tumor diagnosed by Al18F-NOTA-Octreotide PET/CT: A case report[J]. Front Med (Lausanne),2023,10(1):1256176.
[19]	Nagtegaal I D,Odze R D,Klimstra D,et al. The 2019 WHO classification of tumours of the digestive system[J]. Histopathology,2020,76(2):182-188. doi: 10.1111/his.13975
[20]	Seki Y,Sakata H,Uekusa T,et al. Primary hepatic neuroendocrine carcinoma diagnosed by needle biopsy: A case report[J]. Surg Case Rep,2021,7(1):236. doi: 10.1186/s40792-021-01315-3
[21]	Furukawa T,Ozaka M,Takamatsu M,et al. Ki-67 labeling index variability between surgically resected primary and metastatic hepatic lesions of gastroenteropancreatic neuroendocrine neoplasms[J]. Int J Surg Pathol,2021,29(5):475-481. doi: 10.1177/1066896921990715
[22]	唐灿,李向阳,秦浩然,等. 原发性肝脏神经内分泌肿瘤单中心12例诊治与疗效分析[J]. 中华肝脏外科手术学电子杂志,2023,12(6):674-680.
[23]	Wang H H,Liu Z C,Zang G,et al. Clinical characteristics and outcome of primary hepatic neuroendocrine tumors after comprehensive therapy[J]. World J Gastrointest Oncol,2020,12(9):1031-1043. doi: 10.4251/wjgo.v12.i9.1031
[24]	Zhang Z,Zhao X,Li Z,et al. Development of a nomogram model to predict survival outcomes in patients with primary hepatic neuroendocrine tumors based on SEER database[J]. BMC cancer,2021,21(1):567. doi: 10.1186/s12885-021-08337-y
[25]	Qu C,Qu L L,Zhu C Z,et al. Treatment of primary hepatic neuroendocrine tumors with associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): A case report and literature review[J]. Medicine,2018,97(37):e12408. doi: 10.1097/MD.0000000000012408
[26]	Shah D,Mandot A,Cerejo C,et al. The outcome of primary hepatic neuroendocrine tumors: A single-center experience[J]. J Clin Exp Hepatol,2019,9(6):710-715. doi: 10.1016/j.jceh.2019.08.002
[27]	Li S,Niu M,Deng W,et al. Efficacy of chemotherapy versus transcatheter arterial chemoembolization in patients with advanced primary hepatic neuroendocrine carcinoma and an analysis of the prognostic factors: A retrospective study[J]. Cancer Manag Res,2021,13(1):9085-9093.
[28]	Xu J,Shen L,Bai C,et al. Surufatinib in advanced pancreatic neuroendocrine tumours (SANET-p): A randomised,double-blind,placebo-controlled,phase 3 study[J]. Lancet Oncol,2020,21(11):1489-1499. doi: 10.1016/S1470-2045(20)30493-9

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