Fang Yang, Jin Xiuying, Cui Huiying, Han Zhezhu, Xu Qiang, Zhang Songnan
Department of Oncology, Yanbian University Hospital, Yanji, People's Republic of China.
J Hepatocell Carcinoma. 2024 Nov 26;11:2351-2357. doi: 10.2147/JHC.S484272. eCollection 2024.
Primary hepatic Neuroendocrine carcinoma (PHNEC) is exceptionally rare, and when it cannot be surgically removed locally, systemic combination therapy is the preferred treatment. However, current treatments have shown limited effectiveness, and more effective approach remains a matter of debate.
We present a case involving a female patient diagnosed with non-surgically suitable PHNEC, confirmed through pathology. Following four cycles of standard first-line systemic chemotherapy, this intervention was prompted by imaging indicating suboptimal local lesion control, the patient underwent localized interventional and microwave ablation therapy. Subsequently, an evaluation based on mRECIST criteria revealed complete remission post-procedure. The disease sustained this remission status throughout the 14-month follow-up, with the administration of 14 cycles of immunocheckpoint inhibitor maintenance therapy, showing no signs of local recurrence or distant metastasis and devoid of any associated complications.
This case introduces a novel therapeutic avenue for individuals who are ineligible for surgery and have not responded to systemic chemotherapy. The diagnosis and management of PHNEC are deliberated within the framework of this particular case.
原发性肝神经内分泌癌（PHNEC）极为罕见，当无法进行局部手术切除时，全身联合治疗是首选治疗方法。然而，目前的治疗效果有限，更有效的治疗方法仍存在争议。
我们报告一例女性患者，经病理确诊为不适合手术的PHNEC。在进行四个周期的标准一线全身化疗后，由于影像学显示局部病灶控制欠佳，该患者接受了局部介入和微波消融治疗。随后，根据mRECIST标准进行评估，结果显示术后完全缓解。在为期14个月的随访中，该疾病一直保持缓解状态，期间给予了14个周期的免疫检查点抑制剂维持治疗，未出现局部复发或远处转移迹象，也无任何相关并发症。
该病例为不适合手术且对全身化疗无反应的患者引入了一种新的治疗途径。本文在该特定病例的框架内对PHNEC的诊断和管理进行了探讨。
