Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Case Report

Volume 3, Number 4, August 2010, pages 180-184

Primary Small Cell Carcinoma of Liver: A Rare Tumor

Figure 1. Contrast enhanced computed tomography (CECT) abdomen revealed 13.2 x 13.5 x 7.3 cm well defined mass lesion involving segment IV, V and VIII of liver. There was rim enhancement on arterial phase and no contrast retention on venous phase.

Figure 2. Photomicrograph showing A: Organoid and trabecular pattern of tumor cells separated by thin fibrovascular septa; B: Tumor cells with finely granular nuclear chromatin and scanty cytoplasm (Haematoxylin and eosin, x 100, x 400).

Figure 3. A-D: Photomicrograph showing A: Pancytokeratin positivity; B: Neuron specific enolase positivity; C: Synaptophysin positivity and D: Hep Par-1 negativity in tumor cells (Immunostains, x 200).

**Table 1.** Clinicopathological and Immunohistochemical Features of Patients With Primary Small Cell Carcinoma of the Liver
Author	Age /Sex	Symptom	Size (cm)	Stage of Disease	AFP (ng/ml)	Immunohistochemical Staining	Treatment
RUQ, Right upper quadrant; DM, Diabetes mellitus; CT, Chemotherapy; AFP, Alpha-fetoprotein; CEA, Carcinoembryonic antigen; CHR, Chromogranin; CK, Cytokeratin; EMA, Epithelial membrane antigen; NSE, Neuron-specific enolase; SYN, Synaptophysin; TTF-1, Thyroid transcription factor 1.
Ryu et al [11]	56/M	RUQ pain, general weakness	8 cm	Advanced	3.24	(+) CD56, C-kit, SYN; (-) TTF-1	CT (cisplatin, etoposide, irinotecan)
Kim et al [10]	53/M	Palpable mass	12 cm	Advanced	2.94	(+) CD56, NSE, C-kit, SYN, mixed CK, EMA; (-) CK7, 8, 19, 20, AFP, CEA, hepatocyte, vimentin, desmin, TTF-1	Segmentectomy and CT (cisplatin, etoposide)
Zanconati et al [8]	56/M	Abdominal discomfort	5 cm	Limited	> 200	(+) AE1/AE3, CK8, 18, 19, NSE, AFP, ERY-1; (-) S-100 protein, CEA	Partial hepatectomy
Zanconati et al [8]	69/M	DM, weight loss	10 cm	Advanced	-	(+) AE1/AE3, CK 8, 18, 19; (+/-) NSE, CHR; (-) S-100 protein, CEA	-
Zanconati et al [8]	89/M	Jaundice	6 cm	Advanced	150	(+) AE1/AE3, CK 8, 18, 19, AFP, NSE; (-) CHR, S-100 protein, CEA	-
Kim et al [13]	67/M	Abdominal discomfort	12 cm	Advanced	-	(+) SYN, CD56, C-kit; (-) CK, CEA, AFP	CT (cisplatin, epirubicin)
Sengoz et al [9]	73/F	-		Advanced	-		Right hepatectomy
Sengoz et al [9]	66/M	-		-	-		CT (Cisplatin)
Kim et al [2]		-		Advanced		(+) CHR, SYN	-
Choi et al [12]	82/F	Abdominal discomfort	6.7 cm	Advanced	3.4	(+) CD56, NSE, SYN, CHR,TTF-1, C-kit; (-) Antihepatocyte, AFP,vimentin, desmin, CK7, 19, 20, CEA, S-100 protein	Segmentectomy of liver and CT (etoposide)
Morikawa et al [15]	77/M	General fatigue and breathlessness	10 cm	Advanced	27	(+)AE1/AE5, CAM5.2; (-) NSE, desmin, vimentin, CEA	CT (cisplatin, etoposide)
Yang-Qing Huang et al [14]	34/M	Incidental detection		-	-		Right hepatectomy and segment I excision and TACE for recurrance
Index case	40/F	Pain and lump abdomen	13.5 cm	Advanced	2.1	(+) NSE, SYN; (-) TTF1, hep-par 1, CEA	Central bisectionectomy and CT (cisplatin, etoposide)

Table 1. Clinicopathological and Immunohistochemical Features of Patients With Primary Small Cell Carcinoma of the Liver

Author

Age /Sex

Symptom

Size (cm)

Stage of Disease

AFP (ng/ml)

Immunohistochemical Staining

Treatment

RUQ, Right upper quadrant; DM, Diabetes mellitus; CT, Chemotherapy; AFP, Alpha-fetoprotein; CEA, Carcinoembryonic antigen; CHR, Chromogranin; CK, Cytokeratin; EMA, Epithelial membrane antigen; NSE, Neuron-specific enolase; SYN, Synaptophysin; TTF-1, Thyroid transcription factor 1.

Ryu et al [11]

56/M

RUQ pain, general weakness

8 cm

Advanced

3.24

(+) CD56, C-kit, SYN; (-) TTF-1

CT (cisplatin, etoposide, irinotecan)

Kim et al [10]

53/M

Palpable mass

12 cm

Advanced

2.94

(+) CD56, NSE, C-kit, SYN, mixed CK, EMA; (-) CK7, 8, 19, 20, AFP, CEA, hepatocyte, vimentin, desmin, TTF-1

Segmentectomy and CT (cisplatin, etoposide)

Zanconati et al [8]

56/M

Abdominal discomfort

5 cm

Limited

> 200

(+) AE1/AE3, CK8, 18, 19, NSE, AFP, ERY-1; (-) S-100 protein, CEA

Partial hepatectomy

Zanconati et al [8]

69/M

DM, weight loss

10 cm

Advanced

(+) AE1/AE3, CK 8, 18, 19; (+/-) NSE, CHR; (-) S-100 protein, CEA

Zanconati et al [8]

89/M

Jaundice

6 cm

Advanced

150

(+) AE1/AE3, CK 8, 18, 19, AFP, NSE; (-) CHR, S-100 protein, CEA

Kim et al [13]

67/M

Abdominal discomfort

12 cm

Advanced

(+) SYN, CD56, C-kit; (-) CK, CEA, AFP

CT (cisplatin, epirubicin)

Sengoz et al [9]

73/F

Advanced

Right hepatectomy

Sengoz et al [9]

66/M

CT (Cisplatin)

Kim et al [2]

Advanced

(+) CHR, SYN

Choi et al [12]

82/F

Abdominal discomfort

6.7 cm

Advanced

3.4

(+) CD56, NSE, SYN, CHR,TTF-1, C-kit; (-) Antihepatocyte, AFP,vimentin, desmin, CK7, 19, 20, CEA, S-100 protein

Segmentectomy of liver and CT (etoposide)

Morikawa et al [15]

77/M

General fatigue and breathlessness

10 cm

Advanced

(+)AE1/AE5, CAM5.2; (-) NSE, desmin, vimentin, CEA

CT (cisplatin, etoposide)

Yang-Qing Huang et al [14]

34/M

Incidental detection

Right hepatectomy and segment I excision and TACE for recurrance

Index case

40/F

Pain and lump abdomen

13.5 cm

Advanced

2.1

(+) NSE, SYN; (-) TTF1, hep-par 1, CEA

Central bisectionectomy and CT (cisplatin, etoposide)