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

作　　者：臧博 曹景玉[2] 王君[3] 王彦[4] 王连坤 王昌耀[6] 刘斌[1] ZANG Bo;CAO Jingyu;WANG Jun;WANG Yan;WANG Liankun;WANG Changyao;LIU Bin(Department of Rheumatology,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266071,China;Department of Hepatobiliary Surgery,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266071,China;Department of Dermatology,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266071,China;Department of Pathology,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266071,China;Department of Critical Medicine,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266071,China;Department of Orthopedics,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266071,China)

机构地区：[1]青岛大学附属医院风湿免疫科,山东青岛266071 [2]青岛大学附属医院肝胆外科,山东青岛266071 [3]青岛大学附属医院皮肤科,山东青岛266071 [4]青岛大学附属医院病理科,山东青岛266071 [5]青岛大学附属医院重症医学科,山东青岛266071 [6]青岛大学附属医院骨科,山东青岛266071

出　　处：《协和医学杂志》2023年第3期633-637,共5页Medical Journal of Peking Union Medical College Hospital

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。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 hypoproteine⁃mia.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 chal⁃lenge,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.

关 键 词：皮肤肿物 无菌性骨髓炎 肝占位 神经内分泌肿瘤 

分 类 号：R735.7[医药卫生—肿瘤] R575[医药卫生—临床医学]