2017 Volume 57 Issue 3 Pages 205-210
Background. Pulmonary carcinoid tends to be vascular and demonstrates enhancement. Liver metastases of carcinoid tumor complicated by chronic hepatitis can be particularly difficult to diagnose. Case. A 65-year-old man was diagnosed with hepatitis C in 1990. Tumors were discovered in the right lung and liver during a medical checkup in 2011. Although bronchoscopy was performed for the right lung tumor at hospital A, it did not lead to a diagnosis. The liver tumor was regarded as hepatocellular carcinoma in hospital B because of the underlying disease. Therefore, the liver tumor was treated using transcatheter arterial chemoembolization (TACE). After he had been observed in clinic C, he was referred to our hospital because of a rapid increase in the right lung tumor size in 2013. Although the right lung tumor could not be diagnosed by a lung biopsy, a neuroendocrine tumor was diagnosed by a liver biopsy. Liver metastases of pulmonary carcinoid were diagnosed conclusively based on imaging findings. While carboplatin and etoposide therapy was administered initially, the chemotherapy was discontinued because of liver dysfunction. The patient underwent right middle lobe resection and lymph node dissection because of recurring obstructive pneumonia and TACE for the liver metastases. His general condition gradually worsened, and he died three years after the first visit to our hospital. Conclusion. We experienced a case of pulmonary carcinoid with liver metastases complicated by chronic hepatitis C. We believe that an aggressive liver biopsy without regard to the patient background is important for the definitive diagnosis in such difficult cases.
