1Department of Digestive and Life-style Disease, Kagoshima University Graduate School of Medical and Dental Sciences, 2Division of Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 3Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 4Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences
A 40-year-old woman presenting with erythema was admitted to dermatology, where a mass 30 mm in diameter was detected on abdominal computed tomography (CT) at segment 4/8 of the liver. Abdominal ultrasonography (US) showed a hyperechoic mass with cystic change. Contrast-enhanced US revealed homogeneous hyperenhancement in the arterial phase, but consisting of a non-enhanced area with a cystic lesion, and hypoechoic in the post-vascular phase around normal liver parenchyma, with a defect was seen in the Kupffer phase. These findings were not specific for any tumor, so we performed a percutaneous tumor biopsy, and diagnosed primary hepatic neuroendocrine tumor (PHNET). We performed percutaneous transportal embolization before hepatectomy (right trisectionectomy and caudate lobectomy). Immunohistochemically, the tumor cells were positive for the neuroendocrine markers (chromogranin A, synaptophysin) and the Ki-67 index was 1.4%. No primary lesion was found, leading to a classification of primary hepatic neuroendocrine tumor (PHNET) grade 1 and over. PHNET is rare and has a poor prognosis. We report a case of PHNET with a review of the literature.