Chik, Ian and Wai, Jane Yee Chuah and Zamri Zuhdi and Mohd Firdaus Mohd Hayati (2022) Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy. Radiology Case Reports, 17. pp. 1996-2000. ISSN 1930-0433
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Primary neuroendocrine tumor of the liver_ A diagnostic dilemma in the management of liver mass in pregnancy _ABSTRACT.pdf Download (63kB) |
Abstract
Neuroendocrine tumor (NET) commonly occurs in the gastrointestinal tract, however primary NET of the liver is rare, especially during pregnancy. We present a 34-year-old pregnant woman gravida 3 para 2 at 16 weeks period of gestation with primary liver NET discovered incidentally during the antenatal check-up. She has no risk factors for hepatocellular carcinoma. Her serum alpha-fetoprotein was elevated. A plain magnetic resonance imaging (MRI) of the liver delineating a large well-defined exophytic liver mass at segment V/VI measuring 7.1 × 7.4 × 7.8 cm. Given inconclusive MRI findings coupled with low-risk factors of HCC, we had decided to follow up her liver mass with imaging 6 weekly. She then underwent a right hepatectomy with a caesarean delivery at 32 weeks of gestation in the same setting. The histopathological formal report revealed a neuroendocrine tumor, grade 2 with a Ki-67 index of 3% with negative lymphovascular and perineural invasion, but positive for porta hepatis lymph nodes metastasis. A follow up after 1 year shows both patient and her infant are healthy. Antenatal discovery of liver masses poses a diagnostic and management dilemma to clinicians. A multidisciplinary approach and collective decision making are crucial to determine the best approach tailored to the maternal and fetal benefit. In cases of inconclusive non-contrast MRI in pregnancy with low-risk factors and lack of clinical evidence of HCC, follow-up with imaging modalities aiming to intervene at the third trimester can offer safer, and promising outcomes.
Item Type: | Article |
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Keyword: | Case report , Hepatocellular carcinoma , Neuroendocrine tumor |
Subjects: | R Medicine > RC Internal medicine > RC31-1245 Internal medicine > RC581-951 Specialties of internal medicine > RC799-869 Diseases of the digestive system. Gastroenterology |
Department: | FACULTY > Faculty of Medicine and Health Sciences |
Depositing User: | SAFRUDIN BIN DARUN - |
Date Deposited: | 11 Aug 2022 14:55 |
Last Modified: | 11 Aug 2022 14:55 |
URI: | https://eprints.ums.edu.my/id/eprint/33731 |
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