Abstract
Primary hepatic neuroendocrine carcinoma (NEC) is rare, and its origin, clinical features, diagnosis and treatment have not been clarified. Primary mixed NEC and hepatocellular carcinoma (HCC) is even rarer and is divided into either combined type or collision type. We report a patient with the combined type of mixed NEC and HCC. A 72-year-old male was diagnosed with HCC and underwent hepatectomy because of the presence of two tumors in his liver. Histological examination demonstrated that one of the tumors had both NEC and HCC components. The transitional zone was noted in the immunohistological examination, and the tumor was determined to be the combined type of primary mixed NEC and HCC. This was the first description of an HCC component being found in an NEC-dominant area in a primary mixed NEC and HCC tumor. Three weeks after hepatectomy, an abdominal computed tomography scan showed extensive regional and para-aortic lymphadenopathy, and early relapse was suspected in the patient. The patient died 3 months after the operation despite treatment with combination chemotherapy. This report describes an unfavorable case and summarizes all the primary mixed NEC and HCC tumor cases that have been previously reported.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Pilichowska M, Kimura N, Ouchi A, et al. Primary hepatic carcinoid and neuroendocrine carcinoma: clinicopathological and immunohistochemical study of five cases. Pathol Int. 1999;49:318–24.
Kaya G, Pasche C, Osterheld MC, et al. Primary neuroendocrine carcinoma of the liver: an autopsy case. Pathol Int. 2001;51:874–8.
Yasuda E, Takeshita A, Murata S, et al. Neuroendocrine carcinoma of the liver associated with dermatomyositis: autopsy case and review of the literature. Pathol Int. 2006;56:749–54.
Yang CS, Wen MC, Jan YJ, et al. Combined primary neuroendocrine carcinoma and hepatocellular carcinoma of the liver. J Chin Med Assoc. 2009;72:430–3.
Yamaguchi R, Nakashima O, Ogata T, et al. Hepatocellular carcinoma with an unusual neuroendocrine component. Pathol Int. 2004;54:861–5.
Ishida M, Seki K, Tatsuzawa A, et al. Primary hepatic neuroendocrine carcinoma coexisting with hepatocellular carcinoma in hepatitis C liver cirrhosis: report of a case. Surg Today. 2003;33:214–8.
Barsky SH, Linnoila I, Triche TJ, et al. Hepatocellular carcinoma with carcinoid features. Hum Pathol. 1984;15:892–4.
Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24:289–93.
Gurung A, Yoshida EM, Scudamore CH, et al. Primary hepatic neuroendocrine tumour requiring live donor liver transplantation: case report and concise review. Ann Hepatol. 2012;11:715–20.
Touloumis Z, Delis SG, Triantopoulou C, et al. Primary hepatic carcinoid; a diagnostic dilemma: a case report. Cases J. 2008;1:314.
Akahoshi T, Higashi H, Tsuruta S, et al. Primary neuroendocrine carcinoma coexisting with hemangioma in the liver: report of a case. Surg Today. 2010;40:185–9.
Edmondson HA. Tumors of the liver and intrahepatic bile duct. In: Fascicle 25, editor. Atlas of tumor pathology. Washington: Armed Forces Institute of Pathology; 1958. p. 19–29.
Huang YQ, Xu F, Yang JM, et al. Primary hepatic neuroendocrine carcinoma: clinical analysis of 11 cases. Hepatobiliary Pancreat Dis Int. 2010;9:44–8.
Yang K, Cheng YS, Yang JJ, et al. Primary hepatic neuroendocrine tumor with multiple liver metastases: a case report with review of the literature. World J Gastroenterol. 2015;21:3132–8.
Breeman W, de Blois E, Sze Chan H, et al. (68)Ga-labeled DOTA-peptides and (68)Ga-labeled radiopharmaceuticals for positron emission tomography: current status of research, clinical applications, and future perspectives. Semin Nucl Med. 2011;41:314–21.
Buchmann I, Henze M, Engelbrecht S, et al. Comparison of 68 Ga-DOTATOC PET and 111In-DTPAOC(Octreoscan)SPECT in patients with neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2007;34:1617–26.
Rindi G, Arnold R, Bosman FT, et al. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman FT, Carneiro F, Hruban RH, et al., editors. WHO classification of tumours of the digestive system. 4th ed. Lyon: IARC Press; 2010. p. 13–4.
Kano Y, Kakinuma S, Goto F, et al. Primary hepatic neuroendocrine carcinoma with a cholangiocellular carcinoma component in one nodule. Clin J Gastroenterol. 2014;7:449–54.
Sotiropoulos GC, Charalampoudis P, Delladetsima I, et al. Surgery for giant primary neuroendocrine carcinoma of the liver. J Gastrointest Surg. 2014;18:839–41.
Knox CD, Anderson CD, Lamps LW, et al. Long-term survival after resection for primary hepatic carcinoid tumor. Ann Surg Oncol. 2003;10:1171–5.
Mima K, Beppu T, Murata A, et al. Primary neuroendocrine tumor in the liver treated by hepatectomy: report of a case. Surg Today. 2011;41:1655–60.
Dong M, Phan AT, Yao JC. New strategies for advanced neuroendocrine tumors in the era of targeted therapy. Clin Cancer Res. 2012;18:1830–6.
Yao JC, Shah MH, Ito T, et al. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011;364:514–23.
Garcia MT, Bejarano PA, Yssa M, et al. Tumor of the liver (hepatocellular and high grade neuroendocrine carcinoma): a case report and review of the literature. Virchows Arch. 2006;449:376–81.
Nakanishi C, Sato K, Ito Y, et al. Combined hepatocellular carcinoma and neuroendocrine carcinoma with sarcomatous change of the liver after transarterial chemoembolization. Hepatol Res. 2012;42:1141–5.
Artopoulos JG, Destuni C. Primary mixed hepatocellular carcinoma with carcinoid characteristics. A case report. Hepatogastroenterology. 1994;41:442–4.
Tazi EM, Essadi I, M’rabti H, et al. Hepatocellular carcinoma and high grade neuroendocrine carcinoma: a case report and review of the literature. World J Oncol. 2011;2:37–40.
Aboelenen A, El-Hawary AK, Megahed N, et al. Right hepatectomy for combined primary neuroendocrine and hepatocellular carcinoma. A case report. Int J Surg Case Rep. 2014;5:26–9.
Sorbye H, Welin S, Langer SW, et al. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study. Ann Oncol. 2013;24:152–60.
Strosberg J, Coppola D, Klimstra DS, et al. The NANETS consensus guidelines for the diagnosis and management of poorly differentiated (high-grade) extrapulmonary neuroendocrine carcinomas. Pancreas. 2010;39:799–800.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest:
Hiroto Nishino, Etsuro Hatano, Satoru Seo, Shinsuke Shibuya, Takayuki Anazawa, Taku Iida, Toshihiko Masui, Kojiro Taura, Hironori Haga and Shinji Uemoto declare that they have no conflict of interest.
Human Rights:
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed Consent:
Informed consent was obtained from all patients for being included in the study.
Rights and permissions
About this article
Cite this article
Nishino, H., Hatano, E., Seo, S. et al. Histological features of mixed neuroendocrine carcinoma and hepatocellular carcinoma in the liver: a case report and literature review . Clin J Gastroenterol 9, 272–279 (2016). https://doi.org/10.1007/s12328-016-0669-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12328-016-0669-0