Hepatic neuroendocrine neoplasm: imaging patterns

Abstract

<jats:p>Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumors with distinct morphological and biological manifestations, the liver being the main organ affected by its metastases. However, primary hepatic involvement is quite rare. Hepatic NENs can have a variety of radiological presentation forms and can therefore mimic other lesions, making their diagnosis challenging. Nonetheless, certain imaging aspects allow NENs to be included among the main differential diagnoses of hepatic lesions and can guide the search for an extrahepatic primary site when the probable diagnosis is metastases.</jats:p>

Hypovascular pancreatic neuroendocrine tumor with hepatic metastases: A case report and literature review

“…The cystic degeneration of a metastatic hepatic NET can be observed due to necrosis [13 , 14] . In hepatic NET metastases, calcification is uncommon, and hepatic tumors with a fluid-fluid level are highly suggestive of NET metastases [5] . According to Gulpinar et al [14] , arterial phase imaging is especially crucial in patients with NET metastases from the pancreas because 100% of patients with NETs metastases were hyperattenuating on the arterial phase, whereas 80.2% of patients were isoattenuating on the portal venous phase.…”

“…According to Gulpinar et al [14] , arterial phase imaging is especially crucial in patients with NET metastases from the pancreas because 100% of patients with NETs metastases were hyperattenuating on the arterial phase, whereas 80.2% of patients were isoattenuating on the portal venous phase. According to Abdallah et al [5] , the enhancement pattern can suggest the site of the primary NET: a hypervascular tumor without washout on the portal venous phase suggests that the pancreas is the primary tumor site, whereas a hypervascular lesion with washout on the portal venous phase indicates a gastrointestinal origin. In our case, multiple hepatic lesions were heterogeneously hyperenhancing on the arterial phase, demonstrating both slight washout and no washout on the portal venous phase.…”

“…Metastases from NETs account for approximately 10% of all hepatic metastases, and the liver is the most common site for NET metastases. The most common origin of NETs that metastasize to the liver is the gastrointestinal tract, followed by the pancreas [5] . Metastases from NETs typically appear as multiple hypervascular lesions on CT or MRI imaging.…”

Relation between WHO Classification and Location- and Functionality-Based Classifications of Neuroendocrine Neoplasms of the Digestive Tract

“…Primary hepatic-NENs (H-NENs) develop sporadically and are extremely rare, accounting for only 0.3% of all NENs [78] and less than 1% of all primary neoplasms of the liver [79][80][81][82][83]. As the liver is the most frequently affected site of metastases from other (GEP-/GI-)NENs [84,85], the distinction between primary H-NENs and metastases from other locations is important to establish correct treatment and prognosis of patients [74].…”