Case Report of Contrast-Enhanced Ultrasound Features of Primary Hepatic Neuroendocrine Tumor: A CARE-Compliant Article.
Case Report of Contrast-Enhanced Ultrasound Features of Primary Hepatic Neuroendocrine Tumor: A CARE-Compliant Article.
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原发性肝神经内分泌肿瘤的超声造影特征病例报告：CARE 合规文章
DOI：
10.1097/md.0000000000003450
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发表时间：
2016-05
期刊：
影响因子：
1.6
通讯作者：
Wang W
中科院分区：
文献类型：
--
作者：
Li W;Zhuang BW;Wang Z;Liao B;Hong LY;Xu M;Lin XN;Xie XY;Lu MD;Chen LD;Wang W
原发性肝神经内分泌肿瘤(PHNETs)非常罕见，其临床特征和治疗结果尚不清楚。在活检或切除前很难得到正确的诊断。本研究的目的是分析PHNETs在超声造影(CEUS)上的影像特征。对本院收治的6例PHNET患者的临床特点、超声表现、病理特点、治疗及预后进行回顾性分析。PHNETs多见于中年患者，临床表现以右上腹肿块和腹痛最为常见。PHNET常出现多个小的无回声的病灶内空洞。可检出内间隔的多房性囊性病变或伴有壁结节的单房性结节。在超声造影(CEUS)上，大多数患者的动脉期表现为不均匀的高强化和不均匀的低强化，而CT扫描则显示类似的结果。PHNET的诊断是通过免疫组织化学结果和随访证实的，没有肝外原发部位。5例行手术切除，2例复发。1例复发患者行肝动脉化疗栓塞术。仅1例患者接受保守治疗。手术治疗的5例患者的中位总生存期为27个月(18-36个月)。PHNET是一种罕见的肿瘤，诊断困难。本系列中报告的CEU功能可能会丰富PHNET表征的知识库。
Primary hepatic neuroendocrine tumors (PHNETs) are very rare and their clinical features and treatment outcomes are not well understood. It is difficult to reach a proper diagnosis before biopsy or resection. The aim of this study was to analyze the imaging features of PHNETs on contrast-enhanced ultrasound (CEUS). The clinical characteristics, CEUS findings, pathological features, treatment and prognosis of 6 patients with PHNET treated in our hospital were retrospectively analyzed. Most PHNETs occurred in middle-aged patients, and the most common clinical manifestation was right upper quadrant palpable mass and abdominal pain. Multiple small anechoic intralesional cavities occurred frequently in PHNET. Multilocular cystic with internal septation or monolocular with wall nodule could also be detected. On contrast-enhanced ultrasonography (CEUS), heterogeneous hyperenhancement in the arterial phase and wash-out hypoenhancement were observed in most patients, while computed tomography scanning yielded similar results. Diagnosis of PHNET was confirmed by immunohistochemical result and follow-up with the absence of extrahepatic primary sites. Five patients received surgical resection and 2 cases exhibited recurrence. Transcatheter arterial chemoembolization was performed in 1 patient with recurrence. Only 1 patient received conservative care. The median overall survival in 5 patients who underwent surgical treatment was 27 months (18–36 months). PHNET is a rare tumor, and its diagnosis is difficult. The CEUS features reported in this series may enrich the knowledge base for characterization of PHNET.