Primary mixed hepatocellular carcinoma-neuroendocrine carcinoma: A case report

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Introduction: Mixed epithelial neoplasms (MiNENs) are characterised by the coexistence of neuroendocrine and non-neuroendocrine components within a single tumour, each discernible histologically and immunohistochemically, with a minimum tumour proportion of 30%. Primary hepatic MiNENs are exceedingly rare entities.

Aim(s): Case-Report: A 59-year-old male with a history of diabetes and hypertension was admitted for a liver space-occupying lesion. Serum alpha-fetoprotein and abnormal prothrombin levels were elevated. Imaging suggested a possible hepatocellular carcinoma in the liver's right lobe with portal vein tumour thrombus and liver cirrhosis. Laparoscopic right posterior lobe hepatectomy was performed, and pathology revealed a mixed hepatocellular carcinoma (HCC) and large cell neuroendocrine carcinoma (NEC), with HCC 30% and NEC 70%, featuring tumour necrosis, satellite nodules, and intravascular tumour thrombi. The surrounding liver tissue showed cirrhotic changes, and the tumour had a pT3 stage with intact mismatch repair function.

Materials and methods: Discussion: Primary mixed hepatocellular and neuroendocrine liver tumours are rare, with a poor prognosis, often recurring and metastasising postoperatively. Diagnosis requires ruling out metastases and detailed immunohistochemical analysis for neuroendocrine markers. Liver neuroendocrine tumours (NETs) and neuroendocrine carcinomas (NECs) and MiNENs are all extremely rare, and establishing a diagnosis requires excluding metastatic tumours. Literature reports indicate that patients with liver MiNENs have a poor prognosis, worse than that of pure primary hepatocellular carcinoma, with early postoperative recurrence and metastasis being common.

Conference:

Presenting Author: Tang Y

Authors: Wang Y, Wang R, Yi X, Guo M, Tang Y,

Keywords: pancreatic neuroendocrine tumour, functional, parathyroid hormone related peptide,