Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy
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 antenata...
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| Format: | Article |
| Language: | English English |
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Elsevier
2022
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| Online Access: | https://eprints.ums.edu.my/id/eprint/33731/1/Primary%20neuroendocrine%20tumor%20of%20the%20liver_%20A%20diagnostic%20dilemma%20in%20the%20management%20of%20liver%20mass%20in%20pregnancy.pdf https://eprints.ums.edu.my/id/eprint/33731/2/Primary%20neuroendocrine%20tumor%20of%20the%20liver_%20A%20diagnostic%20dilemma%20in%20the%20management%20of%20liver%20mass%20in%20pregnancy%20_ABSTRACT.pdf |
| _version_ | 1825714930873008128 |
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| author | Chik, Ian Wai, Jane Yee Chuah Zamri Zuhdi Mohd Firdaus Mohd Hayati |
| author_facet | Chik, Ian Wai, Jane Yee Chuah Zamri Zuhdi Mohd Firdaus Mohd Hayati |
| author_sort | Chik, Ian |
| collection | UMS |
| description | 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. |
| first_indexed | 2024-03-06T03:19:04Z |
| format | Article |
| id | ums.eprints-33731 |
| institution | Universiti Malaysia Sabah |
| language | English English |
| last_indexed | 2024-03-06T03:19:04Z |
| publishDate | 2022 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | ums.eprints-337312022-08-11T06:55:51Z https://eprints.ums.edu.my/id/eprint/33731/ Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy Chik, Ian Wai, Jane Yee Chuah Zamri Zuhdi Mohd Firdaus Mohd Hayati RC799-869 Diseases of the digestive system. Gastroenterology 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. Elsevier 2022 Article PeerReviewed text en https://eprints.ums.edu.my/id/eprint/33731/1/Primary%20neuroendocrine%20tumor%20of%20the%20liver_%20A%20diagnostic%20dilemma%20in%20the%20management%20of%20liver%20mass%20in%20pregnancy.pdf text en https://eprints.ums.edu.my/id/eprint/33731/2/Primary%20neuroendocrine%20tumor%20of%20the%20liver_%20A%20diagnostic%20dilemma%20in%20the%20management%20of%20liver%20mass%20in%20pregnancy%20_ABSTRACT.pdf 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 https://www.sciencedirect.com/science/article/pii/S193004332200228X https://doi.org/10.1016/j.radcr.2022.03.056 https://doi.org/10.1016/j.radcr.2022.03.056 |
| spellingShingle | RC799-869 Diseases of the digestive system. Gastroenterology Chik, Ian Wai, Jane Yee Chuah Zamri Zuhdi Mohd Firdaus Mohd Hayati Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy |
| title | Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy |
| title_full | Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy |
| title_fullStr | Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy |
| title_full_unstemmed | Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy |
| title_short | Primary neuroendocrine tumor of the liver: A diagnostic dilemma in the management of liver mass in pregnancy |
| title_sort | primary neuroendocrine tumor of the liver a diagnostic dilemma in the management of liver mass in pregnancy |
| topic | RC799-869 Diseases of the digestive system. Gastroenterology |
| url | https://eprints.ums.edu.my/id/eprint/33731/1/Primary%20neuroendocrine%20tumor%20of%20the%20liver_%20A%20diagnostic%20dilemma%20in%20the%20management%20of%20liver%20mass%20in%20pregnancy.pdf https://eprints.ums.edu.my/id/eprint/33731/2/Primary%20neuroendocrine%20tumor%20of%20the%20liver_%20A%20diagnostic%20dilemma%20in%20the%20management%20of%20liver%20mass%20in%20pregnancy%20_ABSTRACT.pdf |
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