Liver collision tumor of primary hepatocellular carcinoma and neuroendocrine carcinoma: A rare case report

Figure 1 Multiple hepatic nodules at the right hepatic lobe and left hepatic tip are recognized. A: The representative larger well-defined lesion, 2.5 cm in size, has obvious hypointensity on the fat-suppressed T1WI; B: Hyperintensity on the fat-suppressed T2WI; C: Significant diffusion restriction with hyperintensity on the diffusion-weighted imaging; D: Dark signal on the apparent diffusion coefficient map at the corresponding site; E-H: Early hyperenhancement & rapid washout.

Figure 2 Hepatocellular carcinoma and neuroendocrine carcinoma tumors. A: Tumor of the right lobe of the liver, 5.7 cm × 5 cm × 4.5 cm, a collision type “hepatocellular carcinoma-hepatic neuroendocrine carcinoma” (HCC-NEC). HCC and NECs coexisted without clear delineation by gross features; B: HE 200X left: NEC, Right: HCC; collision type tumor (right liver tumor). HCC and NEC coexisted and were distinguishable by microscopic features without a focal transition. In addition, HE 400X left: NEC, Right: HCC; C: Synaptophysin 200X LEFT: NEC, right: HCC (collision type, right liver). Synaptophysin positivity in NEC; D: Chromogranin A 200X left: NEC, right: HCC (collision type, right liver). Chromogranin A is positive in NEC; E: A pure HCC (1.6 cm × 1 cm × 0.7 cm) in the resected segment 2 liver.