Primary Hepatic Neuroendocrine Tumor: An Usual Tumor At An Unusual Site

Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and asymptomatic. It is radiologically difficult to distinguish from other liver tumors, such as hepatocellular carcinoma (HCC) and intra hepatic cholangiocarcinoma. A 26 year old man who was referred to us for a liver mass which was discovered during evaluation for altered bowel habits. On abdominal computed tomography and MRI could not offer a conclusive diagnosis. Multiple biopsies were taken from the liver mass elsewhere, which offered variable diagnoses. Immunohistochemical examination revealed a grade 1 neuroendocrine tumor. Serum Chromogranin was grossly elevated. A search for a abdominal primary elsewhere with Esophagogastroduodenoscopy and colonoscopy was negative. A Ga 68 DOTONAC was done which confirmed the presence of liver only lesion. The patient underwent right hepatectomy. PHNETs are extremely rare, with only over 100 cases reported in literature. Because of the rarity of PHNETs, its clinical presentation, diagnosis and treatment outcomes are not well understood. Here, we report our experience with PHNET and its successful management with the help of immunohistochemistry and Ga 68 DOTONAC