Chemoembolization and two-step hepatic resection to treat advanced unresectable metastatic carcinoid tumor

Background: Resection of hepatic metastases of gastroenteropancreatic neuroendocrine tumors is possible in only 10% of cases and authentically curative in only 30%. Results usually depend on the
extent and distribution of the metastases at the time of the intervention. Transcatheter arterial
chemoembolization is an accepted palliative method (with great functional benefit for patients
with hypersecreting tumors) of nonresectable multiple bilobar metastases from endocrine tumors but it does not seem to have the efficacy of resectional therapy. Systemic chemotherapy and somatostatin analogues are other available options to treat non-surgically for long-term palliation of these patients.
Case Report: We describe the case of a 66 years-old man with multiple bilobar metastases from intestinal
carcinoid tumor treated succesfully with chemoembolization and two stage hepatic resection with
curative intention. His excellent response to chemoembolization permitted successful application
of an aggressive resectional approach.
Conclusions: Unresectable multilobular hepatic metastases from carcinoid tumor can occasionally be made resectable with preoperative chemoembolization.

Keywords: arterial chemoembolization, neuroendocrine tumor, hepatic metastases