A Case of Primary Hepatic Neuroendocrine Carcinoma Clinically Suggested.

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  • KAWASATO Ryo
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • SHIRATSUKI Shogo
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • IWAMOTO Takuya
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • SAEKI Issei
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • URATA Yohei
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • HIDAKA Isao
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • ISHIKAWA Tsuyoshi
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • TAKAMI Taro
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • UCHIDA Koichi
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • TERAI Shuji
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • YAMASAKI Takahiro
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine
  • SAKAIDA Isao
    Department of Gastroenterology and Hepatology（Internal Medicine Ⅰ.），Yamaguchi University Graduate School of Medicine

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Other Title
  • 臨床的に肝原発が示唆された神経内分泌癌の一例
  • リンショウテキ ニ カン ゲンパツ ガ シサ サレタ シンケイ ナイブンピツ ガン ノ イチレイ
  • 症例報告 臨床的に肝原発が示唆された神経内分泌癌の一例
  • ショウレイ ホウコク リンショウテキ ニ カン ゲンパツ ガ シサ サレタ シンケイ ナイブンピガン ノ イチレイ

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Abstract

A hepatic tumor was incidentally detected in an 80-year-old man who was undergoing examination for suspected squamous cell carcinoma of the left external auditory canal with positron emission tomography-computed tomography. Subsequently, the patient was referred to our department for further examination and treatment. The identified hepatic tumor was a 20-mm wide, hypervascular, solitary mass, and no associated chronic liver disorders were observed. Blood tests and imaging studies could not yield an appropriate diagnosis, and therefore, a percutaneous hepatic tumor biopsy was performed. On immunohistochemical staining, positive results were obtained for chromogranin A, synaptophysin, and cluster of differenti-ation 56（CD56），whereas the Ki-67 index was 70%, leading to a definite diagnosis of neuroendocrine carcinoma（small cell carcinoma）．Thus, the patient underwent transcatheter arterial chemoembolization（TACE）；however, after 4 months, endoscopic ultrasoundfine needle aspiration biopsy confirmed metastasis to the lymph nodes on the anterior surface of the pancreatic head. The patient underwent symptomatic treatment and was kept under observation；however, he died 14 months after TACE. The primary lesion could not be determined even during autopsy. From the clinical course, we believe that it was highly likely that the patient had a primary hepatic neuroendocrine carcinoma.

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