Liver transplantation as an option of treatment for a giant primary hepatic neuroendocrine tumour

Abstract

There are no clear guidelines for the treatment of hepatic neuroendocrine tumours. Surgical resections — though rarely radical — seem to be the treatment of choice. Thermoablation, chemoembolisation, or cytoreductive surgery of hepatic focal lesions are often recommended.
Pharmacological treatment is based on somatostatin analogues. Liver transplantation is available for a strictly selected group of patients with hepatic neuroendocrine tumours [5]. In the case described above, there were a number of factors that affected the decision about eligibility: first of all — very slow growth of the tumour, its size, and typical multifocality, which made it impossible to perform resection, lack of neoplastic focus outside the liver, and low Ki-67 proliferation index of ≤ 2%. The surgical risk was escalated due to the giant tumour mass and the laparotomy, which was performed twice.