Surgery, The University of British Columbia, Vancouver, British Columbia, Canada
Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
BMJ Case Rep. 2022 Mar 2;15(3):e248527. doi: 10.1136/bcr-2021-248527.
Tumour to tumour metastases are uncommon, and we report a case of carotid body paraganglioma metastatic to a hepatocellular adenoma. A 54-year-old man presented after a CT chest for chronic cough that incidentally identified two liver lesions in segment 3 and caudate. The imaging findings were suspicious for atypical haemangiomas versus hepatocellular adenoma. The segment 3 lesion was biopsied, demonstrating beta-catenin activated hepatocellular adenoma. He underwent partial hepatectomy with pathology showing the beta-catenin activated hepatocellular adenoma contained a central area of paraganglioma. On closer review, the patient revealed a carotid body paraganglioma with lymph node metastases requiring resection 24 years earlier. He subsequently underwent left hepatectomy including the resection bed and caudate, which confirmed the caudate lesion as metastatic paraganglioma. This case demonstrates how paraganglioma can metastasise to liver decades after initial resection and provide insight into the diagnostic workup for hepatocellular adenoma with neuroendocrine features.
肿瘤对肿瘤转移并不常见，我们报告了一例发生于颈动脉体副神经节瘤转移至肝细胞腺瘤的病例。一名 54 岁男性因慢性咳嗽行胸部 CT 检查时偶然发现 3 段和尾状叶有两处肝脏病变。影像学表现提示非典型性肝血管瘤与肝细胞腺瘤的鉴别。3 段病变进行了活检，显示β-连环蛋白激活的肝细胞腺瘤。患者接受了部分肝切除术，病理显示β-连环蛋白激活的肝细胞腺瘤中含有中央副神经节瘤区。进一步回顾病史，患者曾在 24 年前因颈静脉体副神经节瘤伴淋巴结转移而接受过切除术。随后他接受了左半肝切除术，包括切除床和尾状叶，证实尾状叶病变为转移性副神经节瘤。该病例表明副神经节瘤在初次切除几十年后可以转移至肝脏，并为具有神经内分泌特征的肝细胞腺瘤的诊断提供了线索。
