原发性肝脏神经内分泌癌（PHNEC）较罕见，临床症状、体征、超声及影像学检查均不具特异性，病理表现和免疫表型是确诊的主要依据。本例患者因直肠和肝脏特殊的影像学表现，入院初考虑直肠癌伴肝转移，后经病理和免疫组化确诊PHNEC。该病例提示我们临床工作中应警惕因经验主义引起的误诊，应重视病理学诊断结果。

Primary hepatic neuroendocrine carcinoma (PHNEC) is relatively rare. The clinical symptoms, signs, and ultrasound images are not specific. Diagnosis is mainly based on pathological manifestations and immunophenotyping analysis. This individual was initially diagnosed with rectal cancer with liver metastasis because of unclear and inconclusive imaging examination results. The biopsy and immunohistochemical examinations suggested PHNEC. This case suggests that we should be alert to the misdiagnosis caused by empiricism and pay attention to the pathological diagnosis results in clinical work.