Primary carcinoid tumors of the liver

Abstract

Background: Primary carcinoid tumors of the liver are uncommon and rarely symptomatic. The diagnosis of primary hepatic etiology requires rigorous workup and continued surveillance to exclude a missed primary.

Case presentation: We present a case of a 62-year-old female with a primary hepatic carcinoid tumor successfully resected, now with three years of disease-free follow-up. We present a review of the current literature regarding the diagnosis, pathology, management, and natural history of this disease entity.

Conclusion: Primary carcinoid tumors of the liver are rare, therefore classifying their nature as primary hepatic in nature requires extensive workup and prolonged follow-up. All neuroendocrine tumors have an inherent malignant potential that must be recognized. Management remains surgical resection, with several alternative options available for non-resectable tumors and severe symptoms. The risk of recurrence of primary hepatic carcinoid tumors after resection remains unknown.

Figure 1

Ultrasound of the abdomen; Ultrasound of the abdomen depicting a 6.3 × 5.3 × 5.0 heterogenous solid mass in the lateral segment of the left lobe of the liver.

Figure 2

CT scan of the abdomen and pelvis; CT scan of the abdomen and pelvis with IV contrast demonstrates a 4.9 × 4.9 cm enhancing, poorly marginated mass in segment II of the liver.

Figure 3

Gross image of the specimen; The specimen was measured at 5.2 × 5.0 × 5.0 cm and had a tan gray, soft, fish-fleshy cut surface.

Figure 4

Microscopic image of the specimen; The tumor consisted of solid sheets and organoid nests of uniform, intermediate-sized, polyhedral cells in a vascular stroma (Image A) as well as areas of trabecular arrangement with focal stromal hyalinization (Image B).

Figure 5

Immunohistochemistry of the resected specimen; Immunohistochemistry was positive for synaptophysin (Image A) and CD56 (Image B), consistent with a NET.