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多脏器移植患者的具有乳头状特征的原发性肝脏神经内分泌肿瘤

Primary Neuroendocrine Tumor of the Liver With Papillary Features in a Multivisceral Transplant Patient.

作者信息

Khan Jaffar, Jingmei Lin

机构信息

Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, USA.

出版信息

Cureus. 2021 Aug 23;13(8):e17394. doi: 10.7759/cureus.17394. eCollection 2021 Aug.

Abstract

Primary neuroendocrine tumors (NETs) of the liver are rare and difficult to distinguish from other liver tumors such as cholangiocarcinoma and hepatocellular carcinoma. The patient was initially diagnosed with a NET of the liver in 2007. However, the origin of the cancer was not clear, that is, whether it was primary or originated from the gastrointestinal tract. Although the patient underwent partial hepatectomy, he suffered hepatic artery injury, resulting in biliary strictures. The patient eventually became untreatable and developed cirrhosis, a frozen abdomen. He received multivisceral transplantation in May 2019 and received the liver, duodenal-pancreatic complex, spleen, small bowel, and right colon. After the transplantation, the patient did well overall. More recently, he presented with food poisoning and underwent evaluation, and was found to have a mass in the liver. The liver mass was biopsied and revealed a poorly differentiated primary NET (grade 2) with ciliated papillary structures.

摘要

肝脏原发性神经内分泌肿瘤(NETs)较为罕见,且难以与其他肝脏肿瘤如胆管癌和肝细胞癌相区分。该患者于2007年最初被诊断为肝脏NET。然而,癌症的起源并不明确,即它是原发性的还是起源于胃肠道。尽管患者接受了部分肝切除术,但他遭受了肝动脉损伤,导致胆管狭窄。患者最终无法治疗并发展为肝硬化、冰冻腹。他于2019年5月接受了多脏器移植,接受了肝脏、十二指肠 - 胰脏复合体、脾脏、小肠和右结肠。移植后,患者总体情况良好。最近,他出现食物中毒并接受评估,发现肝脏有一个肿块。对肝脏肿块进行活检,结果显示为具有纤毛乳头结构的低分化原发性NET(2级)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b42a/8457678/9e74901117de/cureus-0013-00000017394-i01.jpg

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