A Resected Case Report of Primary Hepatic Carcinoid Tumor Which was Difficult to Make Sure the Diagnosis Preoperatively

Yuji Fujita, Masatoshi Shigeta, Keiji Okamura, Shinobu Tomochika, Makoto Miyahara, Hidefumi Kubo, Yasuhiro Kouchi, Hiroyasu Hasegawa, Hiroshi Miyashita and Yoshimi Yamashita

Department of Surgery, Social Insurance Tokuyama Central Hospital

A primary hepatic carcinoid tumor originating in the liver is rare. We report a resected case of primary hepatic carcinoid tumor difficult to diagnose preoperatively. A 53-year-old woman seen for anemia and a stool test positive for occult blood from April 1999 underwent gastrointestinal and colon fiberscopy, but we could not detect the origin of anemia. Abdominal computed tomography (CT) showed a cystic lesion about 25 mm in diameter in the right hepatic lobe. She was admitted for surgery in January 2003 because the tumor began to grow during follow-up. We conducted right anterior subsegmentectomy (S5) with lymph node cleaning and cholecystectomy because ultrasonography, computed tomography, and angiography suggested cystic adenocarcinoma or atypical hepatocellular carcinoma. The resected specimen was a cystic tumor demarcated by the milk-white fibrous membrene with a hemorrhaging lesion. It had a clear margin from the surrounding parenchyma of the liver. Immunohistologically the tumors were positive for synaptophysin staining and negative for other antigens, leading to a diagnosis of carcinoid in microscopic findings of HE staining. She discharged uneventful 12th postoperative day and was followed carefuly during 10 months after surgery.

Key words
primary hepatic carcinoid, carcinoid tumor, carcinoid syndrome

Reprint requests
Yuji Fujita Department of Surgery, Social Insurance Tokuyama Central Hospital
1-1 Kouda-cho, Syunan-city, 745-8522 JAPAN

Accepted
December 19, 2003

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