Combination Therapy of Hepatic Resection and Radiofrequency Ablation for Primary Hepatic Carcinoid Tumor with Multiple Intrahepatic Metastases; Report of a Case

Noboru Nakamura, Teruo Komokata, Nobuo Hamada³⁾, Ryuji Iwashita, Teruaki Kudama, Yoshihiko Fukukura¹⁾, Shinichi Kitajima²⁾ and Ryuzo Sakata

Department of Thoracic and Cardiovascular Surgery, Hepato-Biliary-Pancreatic Surgery and Department of Radiology¹⁾, Kagoshima University Graduate School of Medical and Dental Sciences
Department of Pathology, Kagoshima University Hospital²⁾
Department of Surgery, Kagoshima City Hospital³⁾

A 55-year-old man with epigastric pain and admitted to treat multiple liver masses was found in preoperative ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) to have a solid 10 cm mass with cystic components in the left lateral segment and multiple small masses in bilateral lobes. Angiography showed a hypervascular mass supplied by the left hepatic artery. We conducted left hepatic lobectomy, partial resection, and radiofrequency ablation (RFA) for all tumors. The resected specimen was a solid tumor with cystic components and a hemorrhagic lesion. Light-microscopy findings showed the tumor to have trabecular, glandular, and rosette structures. Immunohistochemically, tumor cells stained positive for neuron-specific enolase (NSE) and synaptophysin, and stained focally positive for chromogranin A and grimelius. Careful pre- and postoperative examination showed no other tumor origin. In careful follow-up for the primary hepatic carcinoid tumor, the man continues without recurrence in the 6 years since surgery. We report a rare case of primary hepatic carcinoid tumor with a discussion of the literature.

Key words
primary hepatic carcinoid tumors, radiofrequency ablation, hepatic resection

Reprint requests
Noboru Nakamura Department of Thoracic and Cardiovascular Surgery, Hepato-Biliary-Pancreatic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
June 27, 2007

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