Zhang Xinyuan, Yang Huiru, Xin Yujing, Yang Yi, Lu Haizhen, Zhou Xiang
Department of Interventional Therapy, National Cancer Centre/National Clinical Research Centre for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Pathology, National Cancer Centre/National Clinical Research Centre for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2022 May 25;12:893403. doi: 10.3389/fonc.2022.893403. eCollection 2022.
Primary hepatic neuroendocrine tumours (PHNET) are extremely rare. Currently, no evidence-based guidelines are available for PHNET treatment, especially for unresectable tumours.
We present the case of a 43-year-old man who was admitted to our hospital with complaints of backache for more than 1 month. The imaging examination showed a 5.5×5.3 cm lesion in the liver and no extrahepatic lesions, which was confirmed as a grade 2 PHNET by the pathological results and exclusion of non-hepatic origins. A multidisciplinary team (MDT) consultation revealed that the lesion was an unresectable primary hepatic neuroendocrine tumour (uPHNET) but could be potentially treated by conversion surgery. The patient was initially administered four cycles of chemotherapy with temozolomide, 5-fluorouracil, and ondansetron, and was evaluated as stable disease (SD) according to the Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1). Because of the limited clinical benefit of chemotherapy, the patient subsequently underwent transcatheter arterial chemoembolisation (TACE) treatment, which reduced the tumour size and converted uPHNET to resectable tumours. A complete response (CR) was achieved after surgery, and the patient has been disease-free.
This case was reported by a patient with uPHNET who benefited from the pre-operative TACE, providing a potentially effective management strategy for refractory tumours.
原发性肝神经内分泌肿瘤(PHNET)极为罕见。目前,尚无基于证据的PHNET治疗指南,尤其是针对不可切除肿瘤的指南。
我们报告一例43岁男性患者,因背痛1个多月入院。影像学检查显示肝脏有一个5.5×5.3 cm的病灶,无肝外病灶,病理结果及排除非肝源性后确诊为2级PHNET。多学科团队(MDT)会诊显示,该病灶为不可切除的原发性肝神经内分泌肿瘤(uPHNET),但可通过转化手术进行潜在治疗。患者最初接受了四个周期的替莫唑胺、5-氟尿嘧啶和昂丹司琼化疗,根据实体瘤疗效评价标准第1.1版(RECIST 1.1)评估为疾病稳定(SD)。由于化疗的临床获益有限,患者随后接受了经动脉化疗栓塞(TACE)治疗,肿瘤体积缩小,uPHNET转化为可切除肿瘤。术后达到完全缓解(CR),患者无疾病生存。
本文报告了一例受益于术前TACE的uPHNET患者,为难治性肿瘤提供了一种潜在有效的治疗策略。