原发性肝脏神经内分泌癌较为少见，临床表现和影像学不具有特异性，病理诊断为金标准。该病例中患者同时伴有直肠腺癌，在初诊时肝内病灶考虑肠癌转移。在肝脏病灶与直肠病灶评效不一致后，我们行肝脏病灶穿刺病理证实为原发性肝脏神经内分泌癌，但由于患者肝功异常及体力下降未再有治疗机会。该病例提示我们临床工作中需要警惕患者存在多重癌可能，并且获得病理诊断很重要。

Primary hepatic neuroendocrine carcinoma is a rare disease and is short of specific clinical and imaging features. The pathological diagnosis is the gold standard. In this case, the patient presented with rectal adenocarcinoma with multiple liver lesions, which were thought as metastases from rectal cancer. Under the treatment, the primary rectal tumor responded well to the chemotherapy, while the liver lesions progressed rapidly. A biopsy to the liver was then performed, and the pathologic diagnosis revealed primary hepatic neuroendocrine carcinoma. Because of abnormal liver function and poor performance status, the patient was not tolerable for further treatment. This case indicated that we should be aware of the posibility of multiple cancers in clinical work.