Primary Hepatic NET mimicking Hepatocellular Carcinoma: A rare manifestation

Background and Aim: Neuroendocrine tumors of liver are rare, arising predominantly from neuroendocrine cells liver. PHNETs mimics Hepatocellular Carcinoma Cholangiocarcinoma frequently. It is common for HCC to present in the portal delayed phases with prominent arterial enhancement washout, potentially confounding diagnosis PHNET. Case Report: 68/M, diabetic, hypertensive & COAD on regular treatment developed gradual onset upper abdominal heaviness 15 days. The routine investigations including function test was normal serum albumin 3.6 g/dL. Triple phase CT Abdomen suggestive features chronic disease ill-defined heterogeneously enhancing lesion measuring 9 x 7.5 5 cm segment IVa VIII liver, hepatocellular carcinoma. 18F-FDG PET large FDG avid (SUVmax 12.5) ill defined hypodense central area necrosis noted involving 12.9) lytic left scapular (near glenoid cavity), 6th rib laterally sacrum, possibility metabolically active hepatic few skeletal metastasis- likely metastatic HCC. patient had AFP levels 21 ng/mL. However, USG guided biopsy SoL planned. Biopsy tumor. On immunohistochemistry, tumor negative HepPar1, AFP, CK 7 20 positive CD 56. Conclusion: presence a solitary hypervascular under imaging studies no should raise suspicion PHNET patients alpha-fetoprotein levels. Although must be differentiated other masses primary excluded.