Complete resection of large-cell neuroendocrine and hepatocellular carcinoma of the liver: A case report

doi:10.12998/wjcc.v10.i23.8277

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Aug 16, 2022; 10(23): 8277-8283
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8277

Complete resection of large-cell neuroendocrine and hepatocellular carcinoma of the liver: A case report

Byeong Gwan Noh, Hyung-Il Seo, Young Mok Park, Suk Kim, Seung Baek Hong, So Jeong Lee

Byeong Gwan Noh, Hyung-Il Seo, Young Mok Park, Division of HBP Surgery and Transplantation, Department of Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea

Suk Kim, Seung Baek Hong, Department of Radiology, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea

So Jeong Lee, Department of Pathology, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea

Author contributions: All authors contributed to the acquisition of data for this study; Noh BG analyzed the data and wrote the draft manuscript; Seo HI designed the research study; Park YM contributed to the data analysis; Noh BG, Park YM, Seo HI, Kim S, Hong SB, and Lee SJ performed the research; all authors have read and approved the final manuscript.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Hyung-Il Seo, PhD, Professor, Division of HBP Surgery and Transplantation, Department of Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. seohi71@hanmail.net

Received: February 16, 2022
Peer-review started: February 16, 2022
First decision: May 30, 2022
Revised: June 5, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 16, 2022
Processing time: 165 Days and 22.4 Hours

Abstract

BACKGROUND

Combined tumors comprising large-cell neuroendocrine carcinoma and hepatocellular carcinoma have been rarely reported in the literature.

CASE SUMMARY

We report a case of a 73-year-old woman with chronic hepatitis B suspected to have a malignant hepatic mass (segment 3; size, 4.5 cm) and lymph node metastasis based on computed tomography and magnetic resonance imaging. Despite being Child-Pugh class A, esophageal varices were present. She underwent left lateral sectionectomy and lymph node dissection. Pathological examination revealed a collision tumor consisting of large-cell neuroendocrine (90%) and hepatocellular (10%) carcinomas. The combined carcinoma had metastasized to one of the three lymph nodes excised. The patient recovered without any postoperative complications and was discharged in good condition on postoperative day 13. Adjuvant chemotherapy was not performed. No recurrence occurred during a follow-up period of 24 mo.

CONCLUSION

To improve the therapeutic management of combined tumors in the liver, it is necessary to discuss each clinical experience and consider an appropriate method for the preoperative diagnosis and treatment.

Keywords: Hepatocellular carcinoma; Neuroendocrine carcinoma; Chronic hepatitis B; Case report

Core Tip: Collision tumors originating from the liver are extremely rare. No rational surgical strategies for these tumors have been reported because of their rarity, the shortness of knowledge of predictive prognostic factors, the inability to identify progression, and the limited understanding of the biohistology of these lesions. However, complete resection of a resectable locoregional neuroendocrine tumor has excellent outcomes. Because of their rarity, there are no proper guidelines for adjuvant treatment. It is necessary to discuss each clinical experience and consider an appropriate method for the preoperative diagnosis and treatment.