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. 2017 Dec;3(1):12.
doi: 10.1186/s40792-017-0288-0. Epub 2017 Jan 10.

Undifferentiated carcinoma of the liver: a case report with immunohistochemical analysis

Takashi Maeda  1 , Hiroto Kayashima  2 , Daisuke Imai  2 , Kazuki Takeishi  2 , Noboru Harada  2 , Eiji Tsujita  2 , Ayumi Matsuyama  2 , Shinichi Tsutsui  2 , Hiroyuki Matsuda  2
Affiliations

Undifferentiated carcinoma of the liver: a case report with immunohistochemical analysis

Takashi Maeda et al. Surg Case Rep. 2017 Dec.

Abstract

Background: Undifferentiated carcinoma (UC) of the liver is extremely rare, and its clinicopathological characteristics have not been fully elucidated.

Case presentation: The present study reports the case of a 56-year-old male with UC of the liver. At 16 days post-admission, the patient suddenly succumbed due to intra-abdominal bleeding resulting from a ruptured liver. Macroscopic examination revealed that the hepatic parenchyma was almost completely replaced by innumerable minute nodules. Microscopically, the tumor demonstrated a diffuse proliferation of anaplastic cells that were positive for epithelial membrane antigen and neuron-specific enolase, suggesting neuroendocrine differentiation. Grimelius and Fontana-Masson staining were negative. Neuroendocrine markers were also negative, including chromogranin A, synaptophysin, and S-100 protein. Cytokeratin markers and mesenchymal markers were all negative. Tumor markers, such as α-fetoprotein and carcinoembryonic antigen, were also negative.

Conclusions: Although larger studies involving more patients are required to establish a therapeutic strategy, appropriate chemotherapy following an early diagnosis may be important to UC of the liver because the tumor behaves in an aggressive way.

Keywords: Liver cancer; Neuroendocrine carcinoma; Undifferentiated carcinoma.

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Figures

Fig. 1
Fig. 1
Computed tomography. The liver was remarkably swollen and the parenchyma was diffusely rough
Fig. 2
Fig. 2
Macroscopic finding. The hepatic parenchyma was almost completely replaced by innumerable minute nodules
Fig. 3
Fig. 3
Microscopic finding. a A diffuse proliferation of anaplastic cells with hyperchromatic nuclei and scant cytoplasm, with frequent mitotic figures. b Conspicuous portal venous invasion of the tumor cells
Fig. 4
Fig. 4
Immunohistochemical staining. a Neuron-specific enolase was focally positive. b Epithelial membrane antigen was diffusely positive
See this image and copyright information in PMC

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