Korean J Gastroenterol.  2016 Aug;68(2):109-113. 10.4166/kjg.2016.68.2.109.

A Case of Composite Hepatocellular Carcinoma and Neuroendocrine Carcinoma in a Patient with Liver Cirrhosis Caused by Chronic Hepatitis B

• Yun EY
• Kim TH
• Lee SS
• Kim HJ
• Kim HJ
• Jung WT
• Lee OJ
• Song DH

• KMID: 2350089
• DOI: http://doi.org/10.4166/kjg.2016.68.2.109

Abstract

Primary hepatic neuroendocrine carcinoma (PHNEC) is rare and its origin is not clearly understood. The coexistence of PHNEC and hepaotcellular carcinoma has been reported in only a few cases. We report a rare case of combined PHNEC and hepaotcellular carcinoma in a patient with liver cirrhosis caused by chronic hepatitis B that resulted in aggressive behavior and poor prognosis.

Keyword

Neuroendocrine carcinoma; Hepatocellular carcinoma; Hepatitis B; Liver cirrhosis

MeSH Terms

Carcinoma, Hepatocellular*
Carcinoma, Neuroendocrine*
Hepatitis B
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Liver Cirrhosis*
Liver*
Prognosis

Figure

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  Fig. 1. Abdominal CT scan showing tumor of S3 with a high density area in the peripheral part of the mass. (A) Arterial phase showed about 2.4 cm hypervascular nodule in S3 of liver. (B) Portal phase showed heterogeneous enhancing mass. (C) Delayed phase showed pseudo washout sign underlying liver cirrhosis.

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  Fig. 2. (A) MRI showed peripheral hypervascular mass with pseudo washout appearance and heterogeneous T2 signal. (B) MRI showed restricted diffusion.

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  Fig. 3. Cut section of the specimen showed 2.5 cm light gray mass with clear distinction underlying liver cirrhosis.

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  Fig. 4. (A) The neoplastic cells of the neuroendocrine carcinoma (NEC) are separated from hepatocellular carcinoma (HCC) (H&E, ×40). (B) The transition between HCC (left) and NEC (right) (H&E, ×100). (C) Immunostain for CD56 are strongly positive in small round cells (×200). (D) Immunostain for hepatocyte specific antigen showed positive for HCC (×200).

Reference

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