肝 mixed neuroendocrine-non-neuroendocrine neoplasm の 3 切除例

Case 1: A 71-year-old man was diagnosed with S8 hepatocellular carcinoma (HCC) and underwent surgery. Histopathological examination revealed that the tumor was a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). Three months after surgery, multiple intrahepatic recurrences were identified and the patient was treated with transcatheter arterial chemoembolization (TACE). Eleven months after surgery, thoracic spinal metastasis occurred, and the patient died 13 months after surgery. Case 2: A 73-year-old man was diagnosed with S7 HCC and underwent surgery. Histopathological examination revealed MiNEN. Two months after surgery, adrenal and peritoneal metastasis occurred. The patient received systemic chemotherapy, but died 16 months after surgery. Case 3: A 77-year-old woman was diagnosed with S4 HCC and underwent surgery. Histopathological examination revealed MiNEN. Three months after surgery, there were multiple intrahepatic recurrences, peritoneal dissemination, and lymph node recurrences. The patient received systemic chemotherapy, but died six months after surgery. We report three surgical cases of primary hepatic MiNEN in which preoperative diagnosis was difficult. Primary hepatic MiNEN has an extremely poor prognosis and is resistant to conventional multidisciplinary therapies, including surgery, TACE, and systemic chemotherapy.