Carcinoid Liver Tumour



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Carcinoid liver tumour is the term used in certain quarters to refer to carcinoid tumour of the liver.

About 75 % of all carcinoid tumours metastasize to the liver. Primary carcinoid liver tumour (that is, carcinoid tumour originating from the neuro-endocrine cells of the liver, and not a spread from any other site) is extremely rare.

Only 49 cases have been reported in the English literatures till date worldwide (please see reference below). We shall briefly discuss both forms of liver carcinoids.



Primary Carcinoid Liver Tumour

Primary liver carcinoid tumour is extremely rare. Only about 50 cases have been reported thus far (2006) in the English journals. These primary liver carcinoid tumours arise from the neuro-endocrine cells lining the liver channels.

Primary liver carcinoids are usually very benign tumours, and become only symptomatic once they attain to a size of 1cm or more. They may be present as cystic or solid masses in one or more lobes of the liver. There are usually very vascularised (very rich in blood vessels and blood supply) because they derive their blood supply directly from the hepatic artery.

Primary carcinoid liver tumours unlike their metastatic counterpart usually produce gastrin and other non-peptide secretions. They are thus rarely implicated in causing carcinoid syndrome.

Knox et al, in the journal of Annals of Surgical Oncology, reported a case of a 41 year old gentleman who presented with a 3 months of bloating, distension, nausea, loss of appetite, and diffuse abdominal pain. A CT scan revealed a 10 cm mass in the caudate lobe of his liver, with a possible mass on the left liver lobe too.

An encapsulated nodular mass was removed from the caudate lobe with another 4cm mass removed from segment four of his liver. Both masses on histology were proven to primary liver carcinoids, and his symptoms resolved.

They reported recurrence of tumour in this patient who had to under go another more extensive resection, which has cured him of his disease.

Clearly, primary carcinoid liver tumour could respond to resection.

These tumours rarely become malignant. Such carcinoid liver cancer is best treated with palliation. The good news is that despite this been cancerous, their growth rate is usually very slow, and deaths do not come very swiftly.

Palliation for primary carcinoid liver cancer involves the use of hepatic artery embolisation as well as use of somatostatin analogue.

Other carcinoid tumour sites includes:


Tumour of the Appendix and Gut


Carcinoid Tumour of the Lungs

See the main carcinoid page for more information on


Diagnosis

Treament

Prognosis of Carcinoid Liver Tumour and other carcinoid tumours
.




References:

Bailey & Love’s Short Practice of Surgery. 23 rd Edition.

C. D. Knox, C. D. Anderson, L. W. Lamps, R. B. Adkins, and C. W. PinsonLong-Term Survival after Resection for Primary Hepatic Carcinoid TumorAnn. Surg. Oncol., December 1, 2003; 10(10): 1171 - 1175.


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