Primary hepatic neuroendocrine neoplasms: a case series of 10 patients and literature review.

Abstract

The clinical data of 10 patients with pathologically confirmed primary hepatic neuroendocrine neoplasms from Ningbo medical institutions between 2012 and 2024 were retrospectively analyzed. The cohort included 8 males and 2 females, with a median age of 63 years. None presented with carcinoid syndrome. Three cases were detected incidentally during health check-ups, 2 presented with painless jaundice, and 5 reported abdominal distension or pain (1 with concurrent jaundice). Elevated tumor markers included CA199 in 4 cases, AFP in 2, and NSE in 1. All patients underwent surgical resection, including hepatectomy and hepatopancreatoduodenectomy. Preoperative imaging failed to diagnose neuroendocrine neoplasms in all cases. Final pathological diagnoses were neuroendocrine tumor (NET) G2 in 5 cases, NET G3 in 1, and neuroendocrine carcinoma (NEC) in 4. During follow-up (median 27.5 months), 4 patients died and 6 survived. The study demonstrates that primary hepatic neuroendocrine neoplasms are rare and lack specific clinical or imaging features. Diagnosis relies on pathological examination after excluding metastatic disease. Radical resection remains the primary treatment, with prognosis varying significantly by tumor grade.