Royal College of Surgeons in Ireland, Dublin, Ireland.
Allama Iqbal Medical College, Lahore, Pakistan
BMJ Case Rep. 2020 Sep 8;13(9):e236153. doi: 10.1136/bcr-2020-236153.
Primary hepatic neuroendocrine tumour is an exceedingly rare entity. We hereby delineate the case of a 45-year-old Balti descent woman who hails from a land-locked village situated in the foothills of the Pakistani Himalayas. The patient presented to our medical centre with a hepatic mass. She underwent extensive diagnostic workup. The consistent findings of an abdominal CT scan, coupled with her clinical history, insinuated a preoperative diagnosis of atypical hepatic haemangioma. After a detailed discussion in a multidisciplinary meeting, a standard right hemihepatectomy was performed. She had an uneventful postoperative recovery and was discharged in stable condition after 1 week. Surprisingly, pathological examination and immunohistochemistry of the resected specimen divulged the diagnosis of a grade II primary hepatic neuroendocrine tumour. Her somatostatin-receptor scintigraphy and Gallium-68 DOTATATE positron emission tomography scan excluded residual hepatic or additional body lesions. Regular follow-ups over the past 4 years demonstrated unremarkable radiological findings with no recurrence to date.
原发性肝神经内分泌肿瘤是一种非常罕见的实体瘤。我们在此描述了一位 45 岁的巴尔蒂族女性的病例,她来自巴基斯坦喜马拉雅山麓一个内陆村庄。该患者因肝肿块就诊于我们的医疗中心。她接受了广泛的诊断检查。腹部 CT 扫描的一致发现,加上她的临床病史,暗示术前诊断为非典型肝血管瘤。在多学科会议上进行详细讨论后,进行了标准的右半肝切除术。她术后恢复顺利,1 周后稳定出院。令人惊讶的是,切除标本的病理检查和免疫组织化学检查揭示了 II 级原发性肝神经内分泌肿瘤的诊断。她的生长抑素受体闪烁显像和镓 68 DOTATATE 正电子发射断层扫描排除了残留的肝或其他身体病变。过去 4 年来的定期随访显示影像学检查结果无异常,目前尚无复发。