Hu Hai-Xia, Yu Tong
Department of MRI Room, Qinghai Provincial People's Hospital, Xining, Qinghai Province.
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Medicine (Baltimore). 2019 Dec;98(50):e18278. doi: 10.1097/MD.0000000000018278.
Primary hepatic neuroendocrine tumors (PHNET) are extremely rare, which makes it difficult for doctors not deeply to be aware of their imaging and pathological characteristics. Therefore, it is challenging to diagnose PHNET accurately without biopsy or surgical excision. The purpose of this study is PATIENT CONCERNS:: A 52-year-old male patient came to our outpatient department with intermittent upper abdominal pain.
PHNET.
Biochemical examination and imaging examination were performed prior to operation. Liver tumors were removed by ultrasound scalpel under laparoscopy. Pathology examination of liver tumors was performed after operation. Symptomatic supportive treatment was performed after operation as well, including anti-inflammation and rehydration.
The results of biochemical examination were generally normal. The results of MRI showed low signal on T1WI, slightly high signal on T2WI/FS and DWI manifestation of high signal. Immunohistochemistry (IHC) showed that synaptophysin (Syn) was positive, CD56 was positive, chromaffin A (CgA) was positive, and Ki-67 was 15%. The patient was generally in good condition and no discomfort or recurrence was reported during 15 months of follow-up.
The incidence of PHNET is extremely low. Sometimes the patient has no cirrhosis or hepatitis, and alpha-fetoprotein is not high, but imaging examination shows solid occupation and clear boundaries of the liver tumor, for which doctors should consider the primary liver nerve tumor. The diagnosis of PHNET depends on pathological characteristics. Surgical excision is the main method to treat the disease.
原发性肝神经内分泌肿瘤(PHNET)极为罕见,这使得医生难以深入了解其影像学和病理特征。因此,在没有活检或手术切除的情况下准确诊断PHNET具有挑战性。本研究的目的是……患者关注点:一名52岁男性患者因间歇性上腹部疼痛前来我院门诊。
PHNET。
术前进行生化检查和影像学检查。在腹腔镜下用超声刀切除肝肿瘤。术后对肝肿瘤进行病理检查。术后还进行了对症支持治疗,包括抗炎和补液。
生化检查结果基本正常。MRI结果显示T1WI呈低信号,T2WI/FS呈稍高信号,DWI呈高信号。免疫组织化学(IHC)显示突触素(Syn)阳性,CD56阳性,嗜铬粒蛋白A(CgA)阳性,Ki-67为15%。患者一般情况良好,随访15个月期间未报告不适或复发。
PHNET的发病率极低。有时患者无肝硬化或肝炎,甲胎蛋白不高,但影像学检查显示肝脏肿瘤为实性占位且边界清晰,对此医生应考虑原发性肝神经肿瘤。PHNET的诊断取决于病理特征。手术切除是治疗该病的主要方法。