Shi Xianmao, Su Ze, Liang Zhiyin, Sun Xing, Luo Jinwu, Long Zhongrong, Jiang Hongmian, Strosberg Jonathan, Paluri Ravi Kumar, Xiao Yi
Department of Hepatobilliary and Pancreatic Surgery, The First People's Hospital of Nanning, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Pathology, The First People's Hospital of Nanning, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China.
J Gastrointest Oncol. 2024 Aug 31;15(4):1962-1972. doi: 10.21037/jgo-24-571. Epub 2024 Aug 28.
Primary hepatic neuroendocrine carcinoma (PHNEC), which often lacks distinctive radiological features or specific clinical symptoms, is extremely rare. In this report, we describe a rare case of PHNEC that was successfully treated with hepatic arterial infusion chemotherapy (HAIC) combined with camrelizumab and targeted therapy.
This report describes the treatment of a 53-year-old male with PHNEC in China. The patient was admitted for persistent upper right quadrant abdominal pain. Dynamic contrast-enhanced abdominal computed tomography (CT) and magnetic resonance imaging (MRI) both detected multiple masses, enlarged portal lymph nodes, and retroperitoneal lymph nodes. Histological and immunohistochemistry of the largest mass biopsy specimen from the right liver lobe confirmed the neuroendocrine tumor of the liver. The patient underwent HAIC with a modified fluorouracil and oxaliplatin (mFOLFOX) regimen. Meanwhile, the patient received camrelizumab (200 mg, intravenously, q3w) apatinib (250 mg, oral, daily) within 7 days after the start of HAIC. CT and MRI showed a marked decrease in the size of the largest mass of the liver and the portal lymph nodes, indicating a partial response of the tumor.
PHNEC is a very rare tumor, and the treatment for its advanced type is controversial and remains to be standardized. HAIC combined with camrelizumab and targeted therapy may be an effective and safe therapeutic option for patients with PHNEC.
原发性肝神经内分泌癌(PHNEC)极为罕见,通常缺乏独特的放射学特征或特定的临床症状。在本报告中,我们描述了一例罕见的PHNEC病例,该病例通过肝动脉灌注化疗(HAIC)联合卡瑞利珠单抗和靶向治疗获得成功治疗。
本报告描述了一名53岁中国男性PHNEC患者的治疗情况。该患者因持续性右上腹疼痛入院。动态对比增强腹部计算机断层扫描(CT)和磁共振成像(MRI)均检测到多个肿块、肿大的门静脉淋巴结和腹膜后淋巴结。对右肝叶最大肿块活检标本进行组织学和免疫组化检查,证实为肝神经内分泌肿瘤。该患者接受了采用改良氟尿嘧啶和奥沙利铂(mFOLFOX)方案的HAIC治疗。同时,患者在HAIC开始后7天内接受了卡瑞利珠单抗(200mg,静脉注射,每3周一次)和阿帕替尼(250mg,口服,每日一次)治疗。CT和MRI显示肝脏最大肿块及门静脉淋巴结大小明显减小,表明肿瘤部分缓解。
PHNEC是一种非常罕见的肿瘤,其晚期类型的治疗存在争议且仍有待规范。HAIC联合卡瑞利珠单抗和靶向治疗可能是PHNEC患者有效且安全的治疗选择。