Metastatic neuroendocrine carcinoma presenting as multifocal liver lesions with elevated alpha‐fetoprotein

Sobotka, Lindsay; Hake, Timothy; Kelly, Crystal; Mousa, Luay

doi:10.1002/ccr3.1956

Cited by 4 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite recurrences, the resectability rate and overall survival are good. [21,22] Currently, the longest postoperative survival time and the longest disease free survival time for surgically resecting PHNETs is 107 months and 98 months respectively. [11]…”

Section: Discussionmentioning

confidence: 99%

Role of Advanced Imaging in Primary Hepatic Neuroendocrine Tumour with Borderline Raised AFP and Negative Chromogranin Staining: A Case Report

2023

J Surg

View full text Add to dashboard Cite

We present a 68-year-old hypertensive patient with an irregular exophytic lesion showing both solid and cystic components in the left lobe of liver (segment III). Initial laboratory investigations showed elevated Alpha-Fetoprotein (AFP) and GGT with mildly raised SGOT, SGPT and normal Bilirubin. These results pointed to the differential diagnosis of hepatocellular carcinoma and left lobe hepatectomy was performed. Histopathological examination and immunohistochemical staining indicated a neuroendocrine tumor. Radiological imaging (PET CT scan and 68Ga-DOTANOC PET/CT scan) ruled out the evidence of any other metabolically active lesion. Thus, definite diagnosis of Primary Hepatic Neuroendocrine Tumor (PHNET) was established. This case is a very rare presentation of PHNET as not only the AFP levels were raised but also the tumor cells were only positive for synaptophysin and negative for chromogranin.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of Advanced Imaging in Primary Hepatic Neuroendocrine Tumour with Borderline Raised AFP and Negative Chromogranin Staining: A Case Report

2023

J Surg

View full text Add to dashboard Cite

show abstract

“…Increase in the AFP-L3 percentage has been shown to be relatively specific for HCC[ 14 ]. Elevations in AFP have also been reported in the context of metastatic neuroendocrine tumors to the liver[ 15 ]. Serum chromogranin has been used as a marker for tumors with neuroendocrine differentiation and for the monitoring of enterochromaffin-like hyperplasia secondary to treatment with acid secretion inhibitors or atrophic gastritis[ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma with biliary and neuroendocrine differentiation: A case report

Dimopoulos¹,

Winslow²,

He³

et al. 2021

WJCO

View full text Add to dashboard Cite

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.

show abstract

“…Furthermore, nuclear features of neuroendocrine differentiation (e.g., salt and pepper nuclei) are not always evident, particularly in small samples (Arista-Nasr et al 2010). Clinical history of neuroendocrine deregulation (e.g., hormonal imbalances), absence of background liver disease and IHC for neuroendocrine markers including chromogranin A, synaptophysin and -Nasr et al 2010;Jin et al 2016;Sobotka et al 2019). Of note, these markers are also helpful in cases of combined hepatocellular and neuroendocrine carcinoma.…”

Section: Hepatocellular Carcinoma: Histologymentioning

confidence: 99%

The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review

Martins-Filho

Alves

2019

Surg Exp Pathol

View full text Add to dashboard Cite

Careful pathological analysis of hepatocellular carcinoma (HCC) specimens is essential for definitive diagnosis and patient prognostication. Tumor size and focality, gross patterns, macro-and microvascular invasion, degree of histological differentiation and expression of Keratin 19 (K19) are relevant features for risk stratification in this cancer and have been validated by multiple independent cohorts. However, there are important limitations to pathological analyses in HCC. First, liver biopsies are not recommended for diagnosis according to current clinical guidelines. Second, there is limited morphological data from patients at intermediate, advanced and terminal disease stages. Finally, there is little consensus on the evaluation of key histopathological features, notably histological grading (degree of differentiation). Here, we review important morphological aspects of HCC, provide insights to molecular events in relation to phenotypic findings and explore the current limitations to pathological analyses in this cancer.

show abstract

Metastatic neuroendocrine carcinoma presenting as multifocal liver lesions with elevated alpha‐fetoprotein

Cited by 4 publications

References 14 publications

Role of Advanced Imaging in Primary Hepatic Neuroendocrine Tumour with Borderline Raised AFP and Negative Chromogranin Staining: A Case Report

Role of Advanced Imaging in Primary Hepatic Neuroendocrine Tumour with Borderline Raised AFP and Negative Chromogranin Staining: A Case Report

Hepatocellular carcinoma with biliary and neuroendocrine differentiation: A case report

The strengths and weaknesses of gross and histopathological evaluation in hepatocellular carcinoma: a brief review

Contact Info

Product

Resources

About