Imaging features of primary hepatic neuroendocrine carcinoma in 7 cases

LIU Chang-chun; DONG Jing-hui; AN Wei-min; MA Wei; YU Hai-long; REN Hong-wei; HU Hai-dong

doi:10.3969/j.issn.1007-8134.2017.03.012

Abstract：Objective To analyze the imaging features of primary hepatic neuroendocrine carcinoma. Methods Clinical and imaging data of 7 patients with primary hepatic neuroendocrine carcinoma diagnosed by pathology from May 2009 to December 2016 in our hospital were retrospectively analyzed. Results Among the involved 7 patients, there were 5 males and 2 females, they aged from 30 to 65 years old with an average age of 45.6 years old. One patient underwent plain and enhanced CT scan, while the other 6 cases were detected with plain and enhanced MR examination. A total number of 9 lesions were found in 7 patients, and multiple neuroendocrine carcinoma were found in 2 cases with 2 lesions in each case, including 1 patient with Budd Chiari syndrome and the other with hepatocellular carcinoma. Four cases were positive for neuron-specific enolase (NSE) in the serum, while 2 cases showed carcino-embryonic antigen and carbohydrate antigen-199 positive. Besides, all the 7 cases were AFP-negative. The images of the lesions showed the following features: wash in and wash out (5/7), multiple cystic components (6/7), pseudocapsule in the delay phase (4/7), thicken blood vessels (4/7), and draining hepatic veins (4/7). In addition, no portal vein thrombus, lymph node metastasis or bile duct dilatations were found in all 7 cases. Conclusions The imaging findings of neuroendocrine carcinoma show specific features. When a lesion has rich blood supply with no liver disease, single or multiple cystic components, thicken blood vessels, as well as draining veins combined with AFP negative and elevated NSE in the serum, radiologists should consider the possibility of primary hepatic neuroendocrine carcinoma, and the diagnosis still requires biopsy to obtain histopathologic evidence.