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Primary hepatic neuroendocrine tumors: clinical characteristics and imaging features on contrast-enhanced ultrasound and computed tomography

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Abstract

Objective

Primary hepatic neuroendocrine tumor (PHNET) is an extremely rare liver neoplasm, and its clinical characteristics and imaging features are not well understood. The aim of this study was to analyze the clinical profiles and imaging features of PHNETs on contrast-enhanced ultrasound (CEUS) and computed tomography (CT)

Methods

Patients with PHNET between January 2008 and December 2015 were retrospectively identified, and their demographics, laboratory data, and imaging characteristics on CEUS and CT analyzed.

Results

Ten consecutive patients with PHNETs were included (including one G1, seven G2, and two G3 of tumor grades).The median age of patient was 45 years (range: 27–72 years), and 60.0% of patients were male. The most common symptom was abdominal pain (60.0%), and cirrhosis was found in 40.0% of patients. Tumors were confined within the liver in 60.0% of patients, while the remaining patients had extra-hepatic metastasis. The tumors revealed hyperechoic in 60% of patients and mixed echoic in 30% of patients on conventional US, displaying intense arterial enhancement followed by washout in the portal and/or the late phases in 80.0% of patients on CEUS and 60% at CT.

Conclusions

Although PHNET is a very rare liver tumor, it should be considered as a possible differential diagnosis in the management of hepatic tumors. Most PHNETs were hyperechoic or mixed echoic on conventional US, showing similar enhancement patterns to that of hepatocellular carcinoma on CEUS.

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Abbreviations

PHNET:

Primary hepatic neuroendocrine tumor

CT:

Computed tomography

MRI:

Magnetic resonance imaging

AFP:

α–fetoprotein

CEA:

Carcinoembryonic antigen

CA19-9:

Carbohydrate antigen 19-9

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

GGT:

γ-glutamyl transpeptidase

EFSUMB:

European Federation of Societies for Ultrasound in medicine and Biology

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Authors’ contributions

RL designed, planned, and coordinated the study, interpreted the results of CEUS, drafted the manuscript and revised it. CLT collected CEUS data. DY collected CT data and clinical data. XH Z interpreted CEUS images. PC interpreted images of CT. KSM interpreted clinical data, and performed liver surgery and biopsy. DYG interpreted the pathology of PHNET tumor. SYD interpreted images of CT

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Authors and Affiliations

  1. Department of Ultrasound, Southwest Hospital Affiliated to Third Military Medical University, Gaotangyan street, Shapingba, Chongqing, 400038, People’s Republic of China

    Rui Li, Chun-Lin Tang, Dan Yang & Xiao-Hang Zhang

  2. Department of Hepato-biliary-Pancreatic Surgery, Southwest Hospital Affiliated to Third Military Medical University, Chongqing, People’s Republic of China

    Rui Li & Kuan-Sheng Ma

  3. Department of Radiology, Southwest Hospital Affiliated to Third Military Medical University, Chongqing, People’s Republic of China

    Ping Cai & Shi-Yi Ding

  4. Department of Pathology, Southwest Hospital Affiliated to Third Military Medical University, Chongqing, People’s Republic of China

    De-Yu Guo

Authors
  1. Rui Li
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  2. Chun-Lin Tang
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  3. Dan Yang
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  4. Xiao-Hang Zhang
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Corresponding author

Correspondence to Rui Li.

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Conflict of interest

Rui Li, Chun-Lin Tang, Dan Yang, Xiao-Hang Zhang, Ping Cai, Kuan-Sheng Ma, De-Yu Guo, and Shi-Yi Ding declare that they have no conflict of interest.

Ethical approval

Institutional review board approval for this study was obtained from the ethics committee of Southwest hospital

Results involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The need for informed consent of patient was waived by the ethics committee of Southwest hospital in this retrospective study.

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Li, R., Tang, CL., Yang, D. et al. Primary hepatic neuroendocrine tumors: clinical characteristics and imaging features on contrast-enhanced ultrasound and computed tomography. Abdom Radiol 41, 1767–1775 (2016). https://doi.org/10.1007/s00261-016-0770-3

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  • DOI: https://doi.org/10.1007/s00261-016-0770-3

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