Clinicopathological features of neoplasms with neuroendocrine differentiation occurring in the liver

Nomura, Yoshio; Nakashima, Osamu; Akiba, Jun; Ogasawara, Satoshi; Fukutomi, Shogo; Yamaguchi, Rin; Kusano, Hironori; Kage, Masayoshi; Okuda, K; Yano, Hirohisa

doi:10.1136/jclinpath-2016-203941

Cited by 41 publications

(50 citation statements)

References 22 publications

(6 reference statements)

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“…The combined type was more common than the collision type. [ 3 , 6 , 8 – 12 , 14 , 15 ] In the present case, the 2 components were separated by fibrous septae. Occasionally, poorly differentiated HCC was found juxtaposed to the SCC component.…”

Section: Discussionsupporting

confidence: 47%

“…Primary mixed HCC and NEC is very rare. In 1235 hepatic tumors investigated by Nomura et al, [ 14 ] the incidence was 0.46%. Including our patient, there are currently 18 reported cases of HCC with an NEC component in English literature.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] Several studies showed that HCCs with the NEC component are associated with aggressive behavior and a dismal outcome. [ 6 , 8 , 14 , 15 ] Reduced expression of β-catenin is reported to associate with tumor dedifferentiation, lymph node involvement, metastasis, and poor prognosis in pulmonary and gastroenteropancreatic neuroendocrine tumors. [ 16 , 17 ] Loss of E-cadherin/β-catenin integrity is described to initiate epithelial-mesenchymal transition, and is generally considered as an early event preceding tumor invasion.…”

Section: Discussionmentioning

confidence: 99%

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Composite hepatocellular carcinoma and small cell carcinoma with early nodal metastasis

Liu

Ng²,

Huang³

et al. 2017

Medicine

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Rationale:Hepatocellular carcinoma (HCC) is known to grow in a mosaic pattern, and it can sometimes be combined with non-hepatocellular cells. Despites the variety of combination, HCC with a significant neuroendocrine carcinoma (NEC) component remains very rare. Most of the reported cases were treated as conventional HCC with a relatively poor prognosis. Early diagnosis may lead to a better treatment modality. Here, we report a case of composite HCC and small cell carcinoma (SCC) with nodal metastasis of the SCC component alone.Patient concerns:A 65-year-old man with chronic viral hepatitis C presented with abdominal discomfort for 2 months. Computed tomography and angiography of the liver showed a 4.3 cm hypervascular tumor in segment 4 and enlargement of the perihilar and paracaval lymph nodes.Interventions:Extended left lobectomy and regional lymph node dissection were performed.Diagnosis:The hepatic tumor was heterogeneous with two distinct gross components. The green part showed a grade III hepatocellular carcinoma with an immunoreaction to Hep Par 1, glypican 3 and α-fetoprotein, whereas the white part exhibited a small cell carcinoma, as evidenced by expressions of chromogranin A and synaptophysin. The lymph node was metastasized by the SCC component. The SCC part was also positive for vimentin with perivascular accentuation. ß-catenin immunostain showed reduced membranous expression in the SCC component, as compared to HCC.Outcomes:The patient expired 39 days after the surgical intervention.Lessons:Clinicians should be highly alert to a composite hepatic tumor, especially in dealing with a small heterogeneous tumor (< 5 cm) with early lymph node metastasis.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Composite hepatocellular carcinoma and small cell carcinoma with early nodal metastasis

Liu

Ng²,

Huang³

et al. 2017

Medicine

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“…Primary neuroendocrine neoplasms of the liver are very rare (much less common than metastases), accounting for 0.4% of resected hepatic primaries. 31 Because of its rarity, a possibility of metastatic NEN should be excluded before considering a diagnosis of primary hepatic NEN. 5 Histologically, hepatic NETs resemble those that arise in the upper gastrointestinal tract, pancreas, or rectum.…”

Section: Hepatic Neuroendocrine Neoplasmsmentioning

confidence: 99%

“…There are no reports of hepatic G3 NETs in the literature. 5,31 Both small and large cell hepatic NECs resemble those from extrahepatic organs and are typically mixed with a nonneuroendocrine component. Abundant necrosis and mitoses are often present.…”

Section: Hepatic Neuroendocrine Neoplasmsmentioning

confidence: 99%

What is New in the 2019 World Health Organization (WHO) Classification of Tumors of the Digestive System: Review of Selected Updates on Neuroendocrine Neoplasms, Appendiceal Tumors, and Molecular Testing

Assarzadegan

Montgomery

2020

Archives of Pathology &Amp; Laboratory Medicine

112

119

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Context.— The 5th edition of the World Health Organization classification of digestive system tumors discusses several advancements and developments in understanding the etiology, pathogenesis, and diagnosis of several digestive tract tumors. Objective.— To provide a summary of the updates with a focus on neuroendocrine neoplasms, appendiceal tumors, and the molecular advances in tumors of the digestive system. Data Sources.— English literature and personal experiences. Conclusions.— Some of the particularly important updates in the 5th edition are the alterations made in the classification of neuroendocrine neoplasms, understanding of pathogenesis of appendiceal tumors and their precursor lesions, and the expanded role of molecular pathology in establishing an accurate diagnosis or predicting prognosis and response to treatment.

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Mixed neuroendocrine carcinoma and hepatocellular carcinoma in the liver

et al. 2022

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Background Mixed neuroendocrine carcinoma (NEC) and hepatocellular carcinoma (HCC) is extremely rare, thus radiological features have not been fully clarified. Case A male patient (age: 70 years) visited our hospital due to a tumor in the liver. Examination using contrast‐enhanced computed tomography (CT) revealed a tumor (diameter: 5.0 cm) in hepatic segment 5, with early enhancement of the peripheral area and slight internal heterogeneous enhancement in the arterial and delayed phases, respectively. F‐18 fluorodeoxyglucose (FDG)‐positron emission tomography (PET)/CT revealed intratumoral heterogeneity, characterized by increased uptake (standardized uptake value, 12.10) in the corresponding low‐density area detected using enhanced CT relative to the surrounding areas of the tumor. On magnetic resonance imaging, diffusion‐weighted imaging also showed high intensity in the corresponding low‐density area detected using CT. Preoperatively, the patient was diagnosed with HCC and underwent anterior sectionectomy. Pathological findings revealed both HCC and NEC components, and the patient was diagnosed with mixed NEC and HCC. Comparison of component distribution with FDG‐PET/CT revealed an increased uptake area was congruent with the NEC component in the tumor. Conclusion In this case, the difference in tumor components affected the uptake in FDG‐PET/CT. Such heterogeneous uptake with an enhanced spot may be useful for suspecting the presence of mixed NEC and HCC in patients with atypical HCC.

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Clinicopathological features of neoplasms with neuroendocrine differentiation occurring in the liver

Abstract: Primary hepatic NET and NEC are very rare tumours. The NEC component in HNEC showed high proliferative activity and influenced patient prognoses.

Cited by 41 publications

References 22 publications

Composite hepatocellular carcinoma and small cell carcinoma with early nodal metastasis

Composite hepatocellular carcinoma and small cell carcinoma with early nodal metastasis

What is New in the 2019 World Health Organization (WHO) Classification of Tumors of the Digestive System: Review of Selected Updates on Neuroendocrine Neoplasms, Appendiceal Tumors, and Molecular Testing

Mixed neuroendocrine carcinoma and hepatocellular carcinoma in the liver

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