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Hepatocellular carcinoma with biliary and neuroendocrine differentiation: A case report
- Source :
- World Journal of Clinical Oncology
- Publication Year :
- 2021
- Publisher :
- Baishideng Publishing Group Inc., 2021.
-
Abstract
- BACKGROUND Liver tumors with dual differentiations [combined hepatocellular carcinoma (HCC) and cholangiocarcinoma] are common. However, liver tumors that exhibit hepatocellular, biliary, and neuroendocrine differentiation are exceedingly rare, with only three previous case reports in the literature. CASE SUMMARY A 65-year-old female with a previous history of hepatitis C and a distant history of low grade, well-differentiated rectal neuroendocrine tumor was found to have two liver lesions in segment 4 and segment 7 on imaging. Serum alpha-fetoprotein and chromogranin A were elevated. Biopsy of the larger lesion in segment 4 revealed a high-grade tumor, with morphologic and immunohistochemical features of a neuroendocrine tumor. Given the previous history of rectal neuroendocrine tumor, imaging investigation, serologic markers, and biopsy findings, metastatic neuroendocrine tumor was considered. Subsequent regional resection of these hepatic lesions revealed the segment 4 lesion to be a HCC with additional biliary and neuroendocrine differentiation and the segment 7 lesion to be a cholangiocarcinoma with neuroendocrine differentiation. Follow-up of the patient revealed disease recurrence in the dome of the liver and metastasis in retro-pancreatic lymph nodes. The patient eventually expired due to complications of chemotherapy. CONCLUSION HCC cases with additional biliary and neuroendocrine differentiation are exceedingly rare, posing a diagnostic challenge for clinicians and pathologists.
- Subjects :
- 0301 basic medicine
Pathology
medicine.medical_specialty
Neuroendocrine differentiation
Metastasis
Lesion
03 medical and health sciences
0302 clinical medicine
Case report
Biopsy
medicine
biology
medicine.diagnostic_test
business.industry
Biliary
Chromogranin A
Hepatocellular
Hepatitis C
medicine.disease
digestive system diseases
Neuroendocrine
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Mixed liver tumor
biology.protein
Immunohistochemistry
medicine.symptom
business
Triple differentiation
Subjects
Details
- ISSN :
- 22184333
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- World Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....fb7c6524e63884ba0f7e32464c18c91d