Combined Hepatocellular Carcinoma and Neuroendocrine Carcinoma with Ectopic Secretion of Parathyroid Hormone: A Case Report and Review of the Literature

Overview

Journal J Pathol Transl Med

Specialty Biomedical Engineering

Date 2018 May 26

PMID 29794961

Citations 10

Authors

Hyun Jung Kwon

Ji-Won Kim

Haeryoung Kim

YoungRok Choi

Soomin Ahn

Affiliations

Soon will be listed here.

Abstract

Primary combined hepatocellular carcinoma (HCC) and neuroendocrine carcinoma is a rare entity, and so is hypercalcemia due to ectopic parathyroid hormone (PTH) secretion by tumor. A 44-year old man with hepatitis B virus associated chronic liver disease presented with a hepatic mass. Hemihepatectomy discovered the mass as combined HCC and poorly differentiated cholangiocarcinoma. During adjuvant chemoradiation therapy, he presented with nausea, and multiple systemic metastases were found. Laboratory tests revealed hypercalcemia with markedly elevated PTH and neuron specific enolase. Parathyroid scan showed normal uptake in parathyroid glands, suggestive of ectopic PTH secretion. Subsequently, immunohistochemistry of neuroendocrine marker was performed on the primary lesion, and confirmed the neuroendocrine differentiation in non-HCC component. The patient died 71 days after surgery. This report may suggest the possibility of ectopic PTH secretion by neuroendocrine carcinoma of hepatic origin causing hypercalcemia. Caution for neuroendocrine differentiation should be exercised when diagnosing poorly differentiated HCC.

Citing Articles

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Case report: mixed large-cell neuroendocrine and hepatocellular carcinoma of the liver.

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Comparison of Metastatic Patterns Among Neuroendocrine Tumors, Neuroendocrine Carcinomas, and Nonneuroendocrine Carcinomas of Various Primary Organs.

Park H, Kwon G J Korean Med Sci. 2023; 38(11):e85.

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Mixed Primary Hepatocellular Carcinoma and Hepatic Neuroendocrine Carcinoma: Case Report and Literature Review.

Shin W, Lee K, Kim K Medicina (Kaunas). 2023; 59(2).

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A Case of a Rare Parathyroid Hormone (PTH)-Producing Neuroendocrine Tumor.

Quinn C, Chaudhary F, Gould-Simon A, Chen B, Bhandal H, Chaudhary U Am J Case Rep. 2022; 23:e935783.

PMID: 35849548 PMC: 9305989. DOI: 10.12659/AJCR.935783.

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