Neuroendocrine carcinoma of the liver: an autopsy case

An autopsy case of hepatic neuroendocrine carcinoma is described. An 84-year-old man had a white solid tumor measuring 5 cm in greatest diameter and multiple small nodules in the non-cirrhotic liver. Microscopically, these lesions were characterized by solid nesting, trabecular, and insular arrangements of small- to medium-sized cells. The tumor cells were argyrophilic and electron microscopy showed dense core granules and formation of bile canaliculi. Immunohistochemically, the tumor cells were positive for cytokeratin CAM 5.2, chromogranin A, Leu-7, neuron-specific enolase, and alpha-fetoprotein. The tumor was diploid by flow cytometry. The patient had metastases in the vertebrae, lung, pancreas, and an hepatic hilar lymph node. The patient had an occult rectal tumor of intramucosal well-differentiated tubular adenocarcinoma without metastasis. No alternative primary source of the endocrine tumor was detected. The patient died 1 month after presentation.