J Korean Radiol Soc.  2008 Jan;58(1):65-71. 10.3348/jkrs.2008.58.1.65.

Hepatocellular Carcinoma with Neuroendocrine Differentiation: Clinical and Imaging Findings in Five Patients

• Park SH
• Kang MJ
• Cho JH
• Lee JH
• Yoon SK
• Oh JY
• Lee SW
• Han SY
• Jeong JS
• Nam KJ

• KMID: 1479149
• DOI: http://doi.org/10.3348/jkrs.2008.58.1.65

Abstract

PURPOSE: To describe the clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation, which is an extremely rare variant of hepatocellular carcinoma.
MATERIALS AND METHODS
We collected five patients who had histopathologically proven hepatocellular carcinoma with neuroendocrine differentiation, and described morphologic feature, enhancement pattern of tumors, extrahepatic manifestation and clinical findings.
RESULTS
At CT, the tumor size ranged from 8 to 17 cm (mean : 12 cm) in maximum diameter. The tumor margin was well-defined and smooth in four patients and all tumors were heterogeneously hypoattenuating. Four tumor showed rim enhancement on arterial and portal phases. Local invasion to the portal vein, intrahepatic duct and gallbladder were seen. Extrahepatic manifestations included hepatic metastases, lymph node metastasis. At ultrasonography, the tumor showed heterogeneously hyperechoic in all patients and hypoechoic rim was found in four patients. Of four patients who were followed up, one survived for 16 months after initial diagnosis, while the other three died within 3 months after initial diagnosis.
CONCLUSION
As described above, clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation were not specific. However, this rare variant of hepatocellular carcinoma could be considered when hepatic tumor is found in an advanced stage and shows persistent rim enhancement at CT.

Keyword

Carcinoma, hepatocellular; Liver neoplasms; Carcinoma, neuroendocrine

MeSH Terms

Carcinoma, Hepatocellular
Carcinoma, Neuroendocrine
Gallbladder
Humans
Liver Neoplasms
Lymph Nodes
Neoplasm Metastasis
Portal Vein