Masataka Iwao, Makoto Nakamuta, Munechika Enjoji, Hiroaki Kubo, Takayoshi Fukutomi, Yuichi Tanabe, Hidehiro Nishi, Ken-ichi Taguchi, Kazuhiro Kotoh, Hajime Nawata
Med Sci Monit 2001; 7(4): CS746-750
BACKGROUND: Primary hepatic carcinoid tumor (PHCT) is a extremely rare.The authors describe a patient with PHCT and review previously published cases of the disease.
CASE REPORT:A 75-year-old man, presenting with weight loss and pain in the right upper abdomen, had multiple massesin both lobes of the liver. He was diagnosed as PHCT by radiological examination, laboratory findingswith high levels of 5-hydroxyindoleacetic acid (5-HIAA) in the serum and urine, and histological findingsincluding positive staining of tumor cells for Grimelius and chromogranin A. The patient received totallytranscatheter arterial chemoembolization (TACE) five times over 27 months; this treatment provided excellentpalliation and caused a decrease in urinary 5-HIAA levels. Fifty-three cases of PHCT have been reportedin the English-language literature.
RESULTS: Analysis of these published cases revealed that PHCT occursin the middle age (mean age = 48.2 years) and is more frequent in females (males/females = 20/33 cases).Of the symptomatic patients, the major findings is abdominal pain, fullness, and/or a palpable mass (56%of symptomatic patients). In contrast, only 2 cases out of 53 presented with symptoms of typical carcinoidsyndrome. In most cases, PHCT was detected as a hypervascular lesion by radiological examination. Byhistological analysis, 80% and 84% of the cases were positive for Grimelius silver stain and immunohistochemicallypositive for chromogranin A, respectively. Surgical resection is the treatment primarily recommendedwith an 18% of recurrence rate and a 74% of a survival rate after 5 years. For unresectable and recurrentcases, TACE may be recommended.
Keywords: Primary hepatic carcinoid tumor