Small Multiple Carcinoid Tumors Occurring in the Ileum With a Pseudocystic Liver Metastasis

Abstract

A 49‐year‐old woman was admitted to the hospital with a palpable mass in the right hypochondrium. A laparotomy was performed under the clinical diagnosis of a solitary cyst of the liver. The cystic lesion of the liver was removed. Although the histological finding of the cyst wall showed a similarity to hepatocellular carcinoma of trabecular pattern, the tumor cells with uniform nuclei and little mitotic figure were positive for both argyrophil and argentaffin reaction. The pathological diagnosis was metastatic carcinoid tumor of the liver. There was no carcinoid syndrome nor the other clinical symptoms after the operation and various postoperative examinations could not reveal a primary site of the carcinoid tumor. The cystic lesion of the liver recurred ten months after the first operation and a second laparotomy was performed to reveal the primary site in the ileum: three submucosal tumors, 0.8, 0.7, and 0.3 cm. in diameter, two of them, however, extended into the muscle wall or subserosa and conclusively, the small lesion of the ileum metastasized into the liver as a large pseudocystic lesion.

Metastatic Insulinoma Presenting as a Liver Cyst

“…Cystic PanNETs demonstrate indolent clinical behavior compared to solid tumors [5]. Metastatic neuroendocrine tumors are usually solid; however, cystic hepatic metastases of ileal neuroendocrine tumor have been reported [6,7]. Metastatic PanNET presenting as a liver cyst has not been reported in the literature.…”

Cytology as the guiding light: Prompt cytomorphologic diagnosis of cystic metastases from a jejunal neuroendocrine tumor masquerading as hepatic abscesses

“…On radiologic imaging, the metastatic NETs in the liver are mostly seen as solid hypervascular lesions, and presentation as cystic lesions is uncommon 9,10 . To date, there are only a few reports documenting the presentation of metastatic gastrointestinal NETs as hepatic cysts 11–13 . The jejunal NETs are rare and seen mainly in the sixth/seventh decade of life without any gender predilection.…”

A case of pseudocystic liver metastases from an atypical lung carcinoid tumor

“…Cystic hepatic metastases may occur due to necrosis and cystic degeneration of rapidly growing hypervascular tumors or as a manifestation of mucinous colonic or ovarian adenocarcinomas [8]. Our search of the English literature yielded 12 case reports that described pseudocystic or predominantly cystic liver metastases [6], [7], [9], [10], [11], [12], [13], [14], [15], and we evaluated the clinical features and imaging findings of these cases. This group consisted of 4 men and 8 women with a mean age of 60 years (range, 48-68).…”