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Liver transplantation for metastatic neuroendocrine tumor: A case report and review of the literature

摘要Neuroendocrine tumors are divided into gastrointestinal carcinoids and pancreatic neuroendocrine tumors. The WHO has updated the classification of these lesions and has abandoned the term "carcinoid". Both types of tumors are divided into functional and non-functional tumors. They are characterized by slow growth and frequent metastasis to the liver and may be limited to the liver for long periods. The therapeutic approach to hepatic metastases should consider the number and distribution of the liver metastases as well as the severity of symptoms related to hormone production and tumor bulk. Surgery is generally considered as the first line therapy. In patients with unresectable liver metastases,alternative treatments are dependent on the type and the growth rate. Initial treatments consist of long acting somatostatin analogs and/or interferon. Streptozocinbased chemotherapy is usually reserved for symptomatic patients with rapidly advancing disease, but generally the therapy is poorly tolerated and its effects are short-lived.Locoregional therapy directed such as hepatic-artery embolization and chemoembolization, radiofrequency thermal ablation and cryosurgery, is often used instead of systemic therapy, if the disease is limited to the liver.However, liver transplantation should be considered in patients with neuroendocrine metastases to the liver that are not accessible to curative or cytoreductive surgery and if medical or locoregional treatment has failed and if there are life threatening hormonal symptoms. We report a case of liver transplantation for metastatic neuroendocrine tumor of unknown primary source and provide a detailed review of the world literature on this controversial topic.

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作者单位 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland;the Kosciuszko Foundation Awardee in the Division of Gastroenterology at the University of Pennsylvania,Philadelphia, United States [1] Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, United States [2] Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States [3] Department of Magnetic Resonance Imaging Division, University of Pennsylvania, Philadelphia, PA, United States [4]
分类号 R3
发布时间 2006-07-31
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