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頁籤選單縮合
題名 | Combined Primary Neuroendocrine Carcinoma and Hepatocellular Carcinoma of the Liver=原發於肝臟的神經內分泌癌合併肝細胞癌 |
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作者 | 楊啟順; 文美卿; 詹以吉; 王約翰; 吳誠中; | 書刊名 | Journal of the Chinese Medical Association |
卷期 | 72:8 2009.08[民98.08] |
頁次 | 頁403-433+CA79 |
分類號 | 415.5362 |
關鍵詞 | 合併的; 肝細胞癌; 肝臟; 神經內分泌癌; Combined; Hepatocellular carcinoma; Liver; Neuroendocrine carcinoma; |
語文 | 英文(English) |
英文摘要 | We report a unique case of combined primary neuroendocrine carcinoma (NEC) and hepatocellular carcinoma (HCC) of the liver in a 65-year-old male patient. The patient underwent segmental resection of the liver and regional lymph node dissection for a tumor mass that measured 7.5 cm in diameter in the right lobe, with regional lymphadenopathy. Histologically, the hepatic tumor was composed of predominantly small-cell NEC, but admixed with a small island of moderately differentiated HCC. We speculate that the NEC originated from a poorly differentiated tumor clone of an HCC that underwent neuroendocrine differentiation, and that this tumor was now at the end stage of the transitional period from HCC to NEC, based on the small amount of disappearing HCC. Ki-67 and p53 expression were higher in the NEC than in the HCC, and the lymph nodes showed only metastatic NEC. Therefore, this kind of tumor had a more aggressive clinical course in accordance with being an NEC rather than a conventional HCC. Three months after operation, the patient had multiple recurrent tumor nodules within the liver, spreading the metastasis to the adrenal glands and para-aortic lymph nodes. The patient died 1 year after operation. |
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