Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan.
Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan.
Ann Hepatol. 2021 May-Jun;22:100183. doi: 10.1016/j.aohep.2020.01.006. Epub 2020 Feb 13.
A 79-year-old man was admitted to our hospital because of increased hepatobiliary enzyme levels. Dynamic computed tomography and magnetic resonance imaging showed a liver tumor measuring 60mm containing fat foci at the cranial aspect of the tumor. We diagnosed the patient with hypovascular hepatocellular carcinoma (HCC) and fat deposition, and performed a caudate lobe resection. Pathology examination revealed two intermingled components: moderately differentiated HCC with fat deposition and neuroendocrine carcinoma (NEC). Primary combined NEC and HCC is extremely rare. To our knowledge, this is the first report of combined NEC and HCC including a fat component. HCC is the most common primary hepatic malignancy with fat. HCC might include fat, even if HCC coexists with another type of cancer. The imaging characteristics of and HCC with another type of cancer vary depending on the amount of each component. We should not simply diagnose such tumors as HCC, but think about the possibilities of HCC with another type of cancer, because there is a fat component.
一位 79 岁男性因肝生化指标升高而入院。动态计算机断层扫描和磁共振成像显示，肿瘤大小为 60mm，肿瘤头部有脂肪灶。我们诊断为乏血供肝细胞癌（HCC）合并脂肪沉积，并进行了尾状叶切除术。病理检查显示两种混合成分：中分化 HCC 伴脂肪沉积和神经内分泌癌（NEC）。原发性 NEC 和 HCC 合并非常罕见。据我们所知，这是首例报道的包含脂肪成分的 NEC 和 HCC 合并。HCC 是最常见的原发性肝恶性肿瘤伴脂肪。HCC 可能包含脂肪，即使 HCC 与另一种类型的癌症共存。合并另一种类型癌症的 HCC 的影像学特征取决于每个成分的量。我们不应该简单地将此类肿瘤诊断为 HCC，而应该考虑到 HCC 合并另一种类型癌症的可能性，因为存在脂肪成分。
