Primary hepatic neuroendocrine tumor with multifocal liver involvement: A case report and review of the literature.

Primary hepatic neuroendocrine tumors (NETs) are extremely rare, representing approximately 0.3% of all NETs. We report the case of a 30-year-old woman who presented with asymptomatic abdominal distension. Imaging revealed multiple hepatic masses, the largest measuring 195 × 100 × 230 mm in the left lobe. Laboratory tests, including liver function and tumor markers, were normal. Histopathology and immunohistochemistry confirmed a well-differentiated grade 1 neuroendocrine carcinoma with positivity for synaptophysin, CD56, and chromogranin A and a Ki-67 index of 1%. A comprehensive workup excluded an extrahepatic primary tumor. The patient was treated with long-acting lanreotide, and follow-up imaging demonstrated stable lesions with minimal hormonal symptoms. This case highlights the diagnostic challenge of primary hepatic NETs, their often asymptomatic course, and the importance of multidisciplinary evaluation, histological confirmation, and targeted therapy, with surgical resection remaining the mainstay for localized disease while systemic therapy and interventional approaches may be considered in multifocal or unresectable cases.