首发症状为皮肤肿物、皮疹、骨痛的原发性肝脏神经内分泌肿瘤一例

A Case of Primary Hepatic Neuroendocrine Tumor with Skin Lump, Rash and Bone Pain as First Symptoms

摘要: 神经内分泌肿瘤(neuroendocrine tumor, NET)常发生于胃肠道、胰腺等器官，肝脏是最常见的转移性器官，而原发于肝脏的神经内分泌肿瘤(primary hepatic neuroendocrine tumor, PHNET)十分罕见。本文报道1例首发症状为皮肤肿物、皮疹、骨痛，继而出现血糖升高、低蛋白血症的患者，影像学检查发现肝占位性病变，经¹⁸F-OCT与¹⁸F-FDG PET/CT联合显像及病理组织学最终确诊为PHNET。该病例病情复杂难以确诊，且进展迅速、累及多系统，其诊治经验有助于提高临床医师对NET的认识。

Abstract: Neuroendocrine tumors(NETs) commonly occur in organs such as the gastrointestinal tract and pancreas, with the liver being the most common site of metastasis. Primary hepatic neuroendocrine tumors(PHNETs) originating from the liver are exceedingly rare. Herein, we report a case of PHNETs in a patient who presented initially with skin nodules, rash, and bone pain, followed by hyperglycemia and hypoproteinemia. Imaging studies revealed hepatic lesions, and the patient was ultimately diagnosed with PHNETs using ¹⁸F-OCT combined with ¹⁸F-FDG PET/CT and histopathology. The case not only presented a diagnostic challenge, but also exhibited rapid progression involving multiple systems. The experience gained in the diagnosis and treatment of this case may improve clinical awareness of NETs.