Department of Surgery, Beppu Medical Center, 1473 Oaza-Uchikamado, Beppu, Japan.
Surg Today. 2010;40(2):185-9. doi: 10.1007/s00595-009-4018-5. Epub 2010 Jan 28.
Primary hepatic neuroendocrine carcinoma is an extremely rare liver tumor. We herein report a case of primary hepatic neuroendocrine carcinoma coexisting with a hemangioma in a 66-year-old man. Ultrasonography, computed tomography, and magnetic resonance imaging showed a tumor (1.5 cm in diameter) coexisting with a hemangioma in the lateral segment of the liver. Liver biopsy showed malignant cells, and several examinations revealed no alternative primary source. We performed a lateral segmentectomy. Microscopically, the tumor cells had round to oval nuclei and eosinophilic cytoplasm, proliferated in thick trabeculae or solid nests, and formed a focal rosette pattern. Mitotic cells were frequently observed. Immunohistochemically, the tumor cells were positive for the endocrine markers chromogranin A, neuron-specific enolase, and neural cell adhesion molecule, but negative for alpha-fetoprotein and hepatocyte-specific antigen. The patient is still alive after 3 months, without recurrence.
原发性肝神经内分泌癌是一种极罕见的肝脏肿瘤。我们在此报告 1 例 66 岁男性患者,其同时患有原发性肝神经内分泌癌和肝血管瘤。超声、CT 和 MRI 显示肝脏外侧段有 1 个直径为 1.5cm 的肿瘤,同时合并有肝血管瘤。肝活检显示恶性细胞,且多项检查未发现其他原发性肿瘤来源。我们施行外侧段切除术。镜下,肿瘤细胞呈圆形至椭圆形核和嗜酸性细胞质,以厚小梁或实性巢状增生,并形成局灶性玫瑰花结样模式。有丝分裂细胞频繁可见。免疫组化显示,肿瘤细胞内分泌标志物嗜铬粒蛋白 A、神经元特异性烯醇化酶和神经细胞黏附分子阳性,而甲胎蛋白和肝细胞特异性抗原阴性。患者术后 3 个月仍存活,无复发。