A case of primary hepatic neuroendocrine carcinoma clinically suggested

症例は80歳代男性.左外耳道癌(扁平上皮癌)の精査目的で施行された陽電子放射断層撮影･コンピュータ断層撮影にて肝腫瘍を指摘され,精査加療目的で当科に紹介となった.慢性肝障害を伴わない径20mm大の単発性多血性肝腫瘍であり,血液検査及び画像検査所見からは診断に至らなかったため,経皮的肝腫瘍生検が施行された.免疫組織化学的にChromogranin A･Synaptophysin･CD56はいずれも陽性で,Ki-67 indexが70%であったため,神経内分泌癌(小細胞癌)と確定診断された.同病変に対して肝動脈化学塞栓療法(transcatheter arterial chemoembolization

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)

多血性肝腫瘍

神経内分泌腫瘍

肝原発神経内分泌癌