Jarboui Slim, Jerraya Hichem, Moussi Amir, Daldoul Sami, Morched Abdesselem Mohamed, Zaouche Abdeljelil
Service Chirurgie A, Hôpital Charles Nicolle, Tunis.
Tunis Med. 2008 Apr;86(4):386-8.
Primary carcinoid tumour of the liver is rare and poses a diagnostic and management dilemma.
Report a new cases.
A 48 year-old patient man, with an 8-months history of abdominal pain and weight loss, was operated on in December 2000, in another centre with the diagnosis of caudate pancreatic cancer. At laparotomy, Resection was deemed to be not feasible. Histological examination of biopsy was for carcinoid tumor. The patient underwent post operative radiotherapy and four courses of chemotherapy and he was referred to our hospital. Physical examination was normal. Based on radiological examination, the diagnosis was endocrine tumor of the pancreas. The patient underwent relaparotomy, the lesion was independent from the pancreas but linked to the liver; the caudate lobe. Complete macroscopic resection was performed. Histological examination of operative specimen concludes to carcinoid tumor with invasion of hepatic margins. The patient underwent adjuvant chemotherapy; he was free from disease 6 months after surgery.
The diagnostic of primary carcinoid tumors is based principally in the histopathological confirmation of neuroendocrine origin and the exclusion of non hepatic primary tumour. This requires preoperative imaging but most importantly a thorough laparotomy and rigorous follow-up. Surgical resection if possible is recommended.
