A Case of primary hepatic neuroendocrine tumor with prominent calcification

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A 45-year old woman initially presented with a liver mass. Abdominal ultrasound revealed a 14 cm round mass with clear borders in the right hepatic lobe; the mass demonstrated both hyper- and hypoechogenicity with calcification and acoustic shadows. Abdominal computed tomography (CT) showed an expanding mass with a thin capsule, and it consisted of a non-enhanced, hypodense area with prominent calcification and an enhanced, solid peripheral area. Since no primary lesion had been found, the patient was diagnosed as having a primary hepatic malignant tumor for which right lobe hepatectomy was performed. Pathology results showed eosinophilic small tumor cells with trabecular and solid growth patterns with massive necrosis, myxomatous interstitium, and calcification. Immunohistochemical results demonstrated strongly positive synaptophysin and CD56. Primary hepatic neuroendocrine tumor (PHNET), therefore, was confirmed. The MIB-1 index showed 2% in most of the tumor but 5-10% in the rest, leading to a classification of PHNET grade 2. The patient had no recurrence of the mass twelve months post-operatively. This is a rare case of PHNET with prominent calcification.