World Journal of Endocrine Surgery

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VOLUME 11 , ISSUE 3 ( September-December, 2019 ) > List of Articles


Clinical Analysis of Primary Hepatic Neuroendocrine Tumors: Presentation of a Case Report with Intraoperative Carcinoid Crisis and Review of Current Literature

Wojciech M Korcz, Paweł Nyckowski, Gustaw Lech, Michał Mazurkiewicz, Alicja Kwiatkowska, Maciej Słodkowski

Keywords : Carcinoid, Liver, Neuroendocrine tumor, Primary hepatic neuroendocrine tumor

Citation Information : Korcz WM, Nyckowski P, Lech G, Mazurkiewicz M, Kwiatkowska A, Słodkowski M. Clinical Analysis of Primary Hepatic Neuroendocrine Tumors: Presentation of a Case Report with Intraoperative Carcinoid Crisis and Review of Current Literature. World J Endoc Surg 2019; 11 (3):94-99.

DOI: 10.5005/jp-journals-10002-1265

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Introduction: Primary hepatic neuroendocrine tumor (PHNET) is extremely rare and infrequently reported in the literature. Due to the rarity and often asymptomatic clinical features, the diagnosis of PHNET preoperatively is difficult. The aim of the study was to characterize the clinical view, diagnostic tools, and results of surgical treatment of PHNETs. Materials and methods: We report PHNET case with an intraoperatively carcinoid crisis, which is a little-described complication of neuroendocrine tumors (NETs) and can be life-threatening. Published PHNET case series were searched in the PubMed, Medline, and Cochrane Library databases using combinations of relevant terms and were enclosed in the review of the literature. Case Description: A 41-year-old woman was referred due to liver mass incidentally discovered on abdominal ultrasound. The patient underwent resection of hepatic segments: II, III, IVb, V, and cholecystectomy with suddenly hemodynamic instability during surgery. Immunohistochemical and pathological examinations revealed a NETs. Conclusion: This case is interesting because of the rarity of this neoplasm and unexpected life-threatening complications. Primary hepatic neuroendocrine carcinoma should be considered as a possible differential diagnosis in the management of hepatic tumors.

  1. Quartey B. Primary hepatic neuroendocrine tumor: what do we know now? World J Oncol 2011;2(5):209–216. DOI: 10.4021/wjon341w.
  2. Wang LM, An SL, Wu JX. Diagnosis and therapy of primary hepatic neuroendocrine carcinoma: clinical analysis of 10 cases. Asian Pac J Cancer Prev 2014;15(6):2541–2546. DOI: 10.7314/APJCP.2014.15.6.2541.
  3. Jia C, Zhang Y, Xu J, et al. Experience in primary hepatic neuroendocrine tumor. Turk J Gastroenterol 2012;23(5):546–551. DOI: 10.4318/tjg.2012.0370.
  4. Zhang A, Xiang J, Zhang M, et al. Primary hepatic carcinoid tumors: clinical features with an emphasis on carcinoid syndrome and recurrence. J Int Med Res 2008;36(4):848–859. DOI: 10.1177/147323000803600428.
  5. Castillo J, Silvay G, Weiner M. Anesthetic management of patients with carcinoid syndrome and carcinoid heart disease: the mount Sinai algorithm. J Cardiothorac Vasc Anesth 2018;32(2):1023–1031. DOI: 10.1053/j.jvca.2017.11.027.
  6. Yang K, Cheng YS, Yang JJ, et al. Primary hepatic neuroendocrine tumors: multi-modal imaging features with pathological correlations. Cancer Imaging 2017;17(1):20. DOI: 10.1186/s40644-017-0120-x.
  7. Yang K, Cheng YS, Yang JJ, et al. Primary hepatic neuroendocrine tumor with multiple liver metastases: a case report with review of the literature. World J Gastroenterol 2015;21(10):3132–3138. DOI: 10.3748/wjg.v21.i10.3132.
  8. Song JE, Kim BS, Lee CH. Primary hepatic neuroendocrine tumor: a case report and literature review. World J Clin Cases 2016;4(8):243–247. DOI: 10.12998/wjcc.v4.i8.243.
  9. Gravante G, De Liguori Carino N, Overton J, et al. Primary carcinoids of the liver: a review of symptoms, diagnosis and treatments. Dig Surg 2008;25(5):364–368. DOI: 10.1159/000167021.
  10. Yalaf O, Ülku A, Akcam TA, et al. Primary hepatic neuroendocrine tumor: five cases with different preoperative diagnoses. Turk J Gastroenterol 2012;23(3):272–278. DOI: 10.4318/tjg.2012.0465.
  11. Shen YH, Chen S, Zhang WT, et al. Clinical analysis of gastroenteropancreatic neuroendocrine tumor with liver metastasis, compared with primary hepatic neuroendocrine tumor. J Cancer Res Ther 2014;10:276–280. DOI: 10.4103/0973-1482.151532.
  12. Park CH, Chung JW, Jang SJ, et al. Clinical features and outcomes of primary hepatic neuroendocrine carcinomas. J Gastroenterol Hepatol 2012;27(8):1306–1311. DOI: 10.1111/j.1440-1746.2012.07117.x.
  13. Donadon M, Torzilli G, Palmisano A, et al. Liver resection for primary hepatic neuroendocrine tumours: report of three cases and review of the literature. EJSO 2006;32(3):325–328. DOI: 10.1016/j.ejso.2005.11.017.
  14. Knox CD, Anderson CD, Lamps LW, et al. Long-term survival after resection for primary hepatic carcinoid tumor. Ann Surg Oncol 2003;10(10):1171–1175. DOI: 10.1245/ASO.2003.04.533.
  15. DeLuzio MR, Barbieri AL, Israel G, et al. Two cases of primary hepatic neuroendocrine tumors and a review of the current literature. Ann Hepatol 2017;16(4):621–629. DOI: 10.5604/01.3001.0010.0313.
  16. Hwang S, Lee YJ, Lee SG, et al. Surgical treatment of primary neuroendocrine tumorsnof the liver. J Gastrointest Surg 2008;12: 725–730. DOI: 10.1007/s11605-007-0418-2.
  17. Lv Y, Huang C, Xu H, et al. Clinicopathological characteristics of the primary and metastatic hepatic neuroendocrine tumors and the relevant prognosis-related factors: a retrospective study of 81 cases in a single chinese center. J Cancer 2018;9(3): 479–487. DOI: 10.7150/jca.22157.
  18. Lambrescu IM, Martin S, Cima L, et al. Primary hepatic neuroendocrine tumor after 4 years tumor-free follow-up. J Gastrointestin Liver Dis 2015;24(2):241–244. DOI: 10.15403/jgld.2014.1121.242.yrs.
  19. Lin CW, Lai CH, Hsu CC, et al. Primary hepatic carcinoid tumor: a case report and review of the literature. Cases J 2009;2(1):90. DOI: 10.1186/1757-1626-2-90.
  20. Huang YQ, Xu F, Yang JM, et al. Primary hepatic neuroendocrine carcinoma: clinical analysis of 11 cases. Hepatobiliary Pancreat Dis Int 2010;9(1):44–48.
  21. Chen Z, Xiao HE, Ramchandra P, et al. Imaging and pathological features of primary hepatic neuroendocrine carcinoma: an analysis of nine cases and review of the literature. Oncol Lett 2014;7(4):956–962. DOI: 10.3892/ol.2014.1844.
  22. Condron ME, Pommier SJ, Pommier RF. Continuous infusion of octreotide combined with perioperative octreotide bolus does not prevent intraoperative carcinoid crisis. Surgery 2016;159(1):358–365. DOI: 10.1016/j.surg.2015.05.036.
  23. Kaltsas G, Caplin M, Davies P, et al. Antibes consensus conference participants. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: pre- and perioperative therapy in patients with neuroendocrine tumors. Neuroendocrinology 2017;105(3): 245–254. DOI: 10.1159/000461583.
  24. Dierdorf SF. Carcinoid tumor and carcinoid syndrome. Curr Opin Anaesthesiol 2003;16(3):343–347. DOI: 10.1097/00001503-200306000-00017.
  25. Mancuso K, Kaye AD, Boudreaux JP, et al. Carcinoid syndrome and perioperative anesthetic considerations. J Clin Anesth 2011;23(4): 329–341. DOI: 10.1016/j.jclinane.2010.12.009.
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