Non-functional neuroendocrine tumor in a patient with diffuse liver metastases: A case report

Öz

Neuroendocrine tumors arise from neuroendocrine system cells, and constitute a heterogeneous group of neoplasms. In this case report, a case of non-functional neuroendocrine tumor presented with diffuse liver metastases is discussed. In the initial evaluation, massive hepatomegaly was detected in a 62-year-old female admitted to our clinic due to symptoms of abdominal pain and bloating. There was no detectable abnormality except hyperthyroidism in the laboratory studies. Numerous hypodense mass lesions compatible with diffuse hepatic metastases were found in radiological examinations. Liver biopsy showed neuroendocrine tumor in hepatic metastases. No focus was found for the primary site of tumor. Surgical resection as a treatment option was not applicable because of her advanced age and diffuse liver metastases. Long-acting somatostatin analogue was prescribed for the patient. In the follow-up, despite reduction in the patient's symptoms, there was no change in the tumor size. In conclusion, it should be kept in mind that rare neuroendocrine tumors may present with asymptomatic diffuse liver metastases with a non-functional tumor, despite the fact that these tumors have an indolent course.

Anahtar Kelimeler

• Liver, neuroendocrine tumor, hepatic metastases

Diffüz karaciğer metastazı ile başvuran bir hastada fonksiyonel olmayan nöroendokrin tümör: Olgu sunumu

Öz

Nöroendokrin tümörler, nöroendokrin sistem hücrelerinden köken alan heterojen bir neoplazma grubundan oluşmaktadırlar. Bu olgu sunumunda diffüz karaciğer metastazı ile seyreden non-fonksiyone bir nöroendokrin tümör olgusu tartışılmıştır. Kliniğimize karın ağrısı ve karında şişlik şikayetleri ile başvuran 62 yaşındaki bayan hastanın yapılan ilk değerlendirmesinde masif hepatomegali saptandı. Laboratuar incelemelerinde hipertiroidi dışında anlamlı bir bulgu bulunmadı. Radyolojik incelelemelerde ise karaciğerde diffüz metastazla uyumlu çok sayıda hipodens kitle lezyonları saptandı. Yapılan karaciğer biyopsisi, hepatik nöroendokrin tümör metastazı ile uyumlu bulundu. Hastada primer odak bulunamadı. Diffüz karaciğer tutulumu birlikte hastanın yaşının ileri olması nedeni ile cerrahi rezeksiyon duşünülmedi. Hastaya uzun etkili somatostatin analoğu başlandı. Takiplerde hastanın semptomları gerilemesine rağmen radyolojik bulgularda gerileme gözlenmedi. Sonuç olarak nadir görülen nöroendokrin tümörlerin alışılageldiği yavaş seyrinin aksine tümüyle yakın zamana kadar asemptomatik seyretmesine karşın, yaygın karaciğer metastazıyla birlikte afonksiyone olarak prezente olabileceği göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Karaciğer, nöroendokrin tümör, hepatik metastaz

Kaynakça

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