Primary hepatic functional neuroendocrine tumor in an elderly female: Case report

Key Clinical MessagePrimary hepatic neuroendocrine tumor, an exceptionally rare subtype, poses a diagnostic challenge. Oncological resections should be considered, even in elderly patients after following protocolized pre-operative optimizations.AbstractNeuroendocrine tumors (NETs) are rare tumors that primarily develop in the gastrointestinal and respiratory tracts. While the liver is commonly affected by NET metastases, primary hepatic neuroendocrine tumors (PHNETs) are an exceptionally rare subtype. The characteristic slow growth and nonfunctional nature of PHNETs pose challenges in their diagnosis. Furthermore, PHNETs often exhibit a lack of unique radiological characteristics that differentiate them from other liver tumors, leading to frequent misdiagnosis as hepatocellular carcinoma. We performed left hepatectomy for PHNET in an elderly lady with prolonged stormy postoperative course. This case report of a PHNET highlights the importance of histopathology and immunohistochemistry in the diagnosis and emphasizes that oncological resection, if feasible, is the preferred treatment even in the elderly population. Preoperative images. (a, b) Triple phase CECT abdomen revealed a 5.8 x 6 x 6.2 cm heterogeneous hypodense lesion involving segments IVa and IVb of liver (white arrow) with nodular enhancement on arterial phase, early washout in venous and delayed phases. (c) 18-FDG PET-CT did not reveal any focus of increased FDG uptake. (d) DOTANOC PET CT showed a SSTR-expressing lesion in left lobe of liver (white arrow) with no disease elsewhere.image