title: Neuroendocrine liver metastasis in gastric mixed adenoneuroendocrine carcinoma with trilineage cell differentiation: a case report.
abstract: Mixed adenoneuroendocrine carcinoma (MANEC) is a rare disease, which mostly occurs in the gastrointestinal tract and pancreas. Here we report a case of gastric MANEC with tri-lineage differentiation in which only the neuroendocrine component had metastasized to the liver. Liver and gastric masses were detected by abdominal computed tomography, and the preoperative relationship between liver and gastric masses was unknown. The histopathological analysis after operation confirmed the gastric mass to be MANEC, whereas the liver mass was actually the metastatic neuroendocrine component of the gastric MANEC. In the pathologic diagnosis, tri-lineage differentiation, including tubular adenocarcinoma, neuroendocrine carcinoma and squamous cell carcinoma was observed in the gastric MANEC tissues. The mitotic and Ki-67 labeling indexes of the resected tumor tissue were high, and thus, the tumor was classified as a grade G3 neuroendocrine carcinoma, which has a poor prognosis. Multiple low-density masses were found in the right lobe of the liver 2.5 months after operation.
authors.affiliation: Division of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Wenjin
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Division of Pathology, Beilun People's Hospital 1288 Lushan East Road, Ningbo 315800, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Xiao
authors.affiliation: Division of Pathology, Beilun People's Hospital 1288 Lushan East Road, Ningbo 315800, China.
authors.forename: Haifen
authors.initials: H
authors.lastname: Ma
authors.affiliation: Division of Pathology, Beilun People's Hospital 1288 Lushan East Road, Ningbo 315800, China.
authors.forename: Mingfei
authors.initials: M
authors.lastname: Sun
authors.affiliation: Division of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Hongtan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Division of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine 79 Qingchun Road, Hangzhou 310003, China.
authors.forename: Shusen
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D018278:Carcinoma, Neuroendocrine / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D002454:Cell Differentiation; D019070:Cell Lineage; D005743:Gastrectomy; D005773:Gastroscopy; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D008297:Male; D008940:Mitotic Index; D018193:Neoplasms, Complex and Mixed / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor
keywords: Mixed adenoneuroendocrine carcinoma; differentiation; gastroenteropancreatic neuroendocrine tumor; immunohistochemistry