Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2018; 10(10): 780-784
Published online Oct 27, 2018. doi: 10.4254/wjh.v10.i10.780
Neuroendocrine tumor incidentally detected during living donor hepatectomy: A case report and review of literature
Sami Akbulut, Burak Isik, Egemen Cicek, Emine Samdanci, Sezai Yilmaz
Sami Akbulut, Burak Isik, Sezai Yilmaz, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Egemen Cicek, Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Emine Samdanci, Department of Pathology, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Author contributions: Akbulut S, Isik B, and Cicek E designed the report; Akbulut S collected the patient’s clinical data; Samdanci E provided histopathological information; Akbulut S and Yilmaz S analyzed the data and wrote the paper.
Informed consent statement: The patient involved in this study gave his informed written consent prior to study enrollment, authorizing the use and disclosure of his protected health information.
Conflict-of-interest statement: The author declares no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sami Akbulut, MD, Associate Professor, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Elazig Yolu 10. Km, Malatya 44280, Turkey. akbulutsami@gmail.com
Telephone: +90-422-3410660 Fax: +90-422-3410036
Received: May 18, 2018
Peer-review started: May 18, 2018
First decision: June 6, 2018
Revised: June 19, 2018
Accepted: June 27, 2018
Article in press: June 28, 2018
Published online: October 27, 2018
Abstract

To our best knowledge, no case of a tumor that was incidentally detected during living donor hepatectomy (LDH) has been reported in the English language medical literature. We present two cases in which grade I neuroendocrine tumors (NET) were incidentally detected during our twelve-year LDH experience. First Case: A 26-year-old male underwent LDH for his brother suffering from HBV-related chronic liver disease (CLD). After right lobe LDH, intestinal length was measured as part of a study concerning the relationship between small intestinal lengths and surgical procedure. At this stage, a mass lesion with a size of 10 mm × 10 mm was detected on the antimesenteric surface, approximately 90 cm proximal to the ileocecal valve. A wedge resection with primary intestinal anastomosis was performed. Second Case: A 29-year-old male underwent right lobe LDH for his father with hepatitis B virus (HBV)-related CLD. An abdominal exploration immediately prior to the closure of the incision revealed that the appendix vermiformis was edematous and had firmness with a size of 8-10 mm at its tip. An appendectomy was performed. The pathological examinations of the specimens of both patients revealed grade 1 NET. In conclusion, even if patients undergoing LDH are healthy individuals, whole abdominal cavity should be gently palpated and all findings recorded after completing laparotomy. Suspected masses or lesions should be confirmed by frozen section examination. Such an approach would avert potential medicolegal issues.

Keywords: Living donor hepatectomy, Incidental tumor, Neuroendocrine tumor, Chronic liver disease, Hepatitis B virus

Core tip: To our best knowledge, no case of a tumor that was incidentally detected during living donor hepatectomy (LDH) has been reported in the English language medical literature. Herein, we present two cases in which grade I neuroendocrine tumors were incidentally detected during our twelve-year LDH experience. Even if patients undergoing LDH are healthy individuals, the whole abdominal cavity should be gently palpated and all findings be recorded after completing laparotomy. Suspected masses or lesions should be confirmed by frozen section examination. Such an approach would avert potential medicolegal issues.