Tumor carcinoide hepático. A propósito de un caso

Abstract

Introduction: Hepatic carcinoid tumor (HCT) is a rare finding, it represents 0.3% of all carcinoid tumors (TC). It is usually asymptomatic, being one of the most frequent forms of presentation the palpable abdominal mass. Clinical Case: Male patient, 39 years old, who consulted for presenting a clinical picture of 6 months of evolution, characterized by abdominal pain located in the epigastrium, dyspeptic symptoms and weight loss. On physical examination, he presented abdominal pain in the epigastrium, palpable, non-painful hepatomegaly and no evidence of lymphadenopathy. Results: For the diagnostic study, the following was performed: Abdominal echogram, which reported hepatosplenomegaly, hepatic solid LOE. Triphasic CT of the liver with hepatosplenomegaly, LOE indicative of a probable primary neoplasm in the right hepatic lobe and secondary infiltrative lesion in the left lobe, as well as multiple MT-like pulmonary nodules. A CT-guided liver biopsy was performed, showing hepatocellular injury and hepatic steatosis. Chest CT shows solid pulmonary nodules with MT appearance, hepatic lesions with TU appearance, osteoblastic lesions in probable MT relationship; Upper and lower digestive endoscopy with antral congestive gastropathy, bile duodenal reflux and resected polyp in cecum 0-1S, respectively. With laparoscopic liver biopsy, which reports metastatic adenocarcinoma. Finally, the immunohistochemical study, high-grade poorly differentiated large cell neuroendocrine carcinoma, primary vs. metastatic liver. Conclusions. The (HCT) are exceptional. A recurrence of 18% has been estimated, which makes it necessary to insist on the importance of strict follow-up.