Three Cases of Primary Hepatic Neuroendocrine Tumor Treated with Surgical Resection: A Case Series and Literature Review

Abstract

ABSTRACT INTRODUCTION Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare, accounting for approximately 0.3% of all neuroendocrine tumors (NETs). Because the liver is the most common metastatic site of NETs, distinguishing PHNET from metastatic disease is often challenging. Optimal treatment strategies and follow-up protocols for PHNET have not been well established. We report 3 cases of PHNET treated with surgical resection. CASE PRESENTATION Case 1 involved a 42-year-old woman with a liver tumor detected during a routine medical examination. Laparoscopic partial hepatectomy was performed under the preoperative diagnosis of hepatic adenoma or hemangioma. Histopathological examination revealed a NET, grade 2. The patient developed intrahepatic recurrence 5 years and 8 months after the initial surgery and underwent repeat hepatectomy. Case 2 involved a 72-year-old woman diagnosed with PHNET (grade 2) by liver biopsy. Laparoscopic extended posterior sectionectomy was performed. Intrahepatic recurrence occurred 3 years and 9 months later, and repeat hepatectomy was performed. Case 3 involved a 50-year-old man diagnosed with NET (grade 1) by endoscopic US-guided fine-needle aspiration. Extended left hepatectomy with partial resection of segment 8 was performed. He remains recurrence-free. In all cases, comprehensive examinations, including endoscopy, somatostatin receptor imaging (SRI), and PET, revealed no evidence of extrahepatic primary lesions, leading to the diagnosis of PHNET. CONCLUSIONS PHNET is a rare tumor that may recur several years after curative resection. Careful long-term follow-up is therefore required, and repeat surgical resection may be an effective treatment option for selected patients with recurrent disease.