Synchronous hepatocellular carcinoma and gallbladder adenocarcinoma with neuroendocrine differentiation: a case report and literature review

Abstract Background Double primary cancers have a low incidence rate, and synchronous hepatocellular carcinoma and gallbladder adenocarcinoma are rarely reported. Here, we report such a case— the 12th case of synchronous double primary cancers featuring HCC and GC, but the first case of neuroendocrine differentiation in the gallbladder. Case presentation A 77-year-old female was admitted to the hospital complaining of weakness and inappetence for six months. Contrast-enhanced computed tomography (CT) of the abdomen indicated an 11 cm space-occupying lesion in the right lobe of the liver. Later, magnetic resonance imaging showed a high possibility of a massive hepatoma, and multiple gallstones were also seen. After transhepatic arterial chemoembolization, a repeat abdominal CT showed obvious local nodular thickening in the gallbladder wall. Finally, resection of the right lobe of the liver and cholecystectomy were performed. During an approximately 2-year follow-up, the patient recovered uneventfully without recurrence or metastasis. Conclusion The disease in this case is rare and lacked typical radiological features. More precise and advanced diagnostic techniques are needed to obtain a clear diagnosis and refine treatment strategies. The management strategy should always be curative, even in the presence of multiple malignancies.

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Case Report: Robotic ALPPS Procedure for Hepatocellular Carcinoma in the Right Lobe of the Liver

Frontiers in Surgery ◽

10.3389/fsurg.2021.655683 ◽

2021 ◽

Vol 8 ◽

Author(s):

Evgeny Solomonov ◽

Itamar Tzadok ◽

Salomon Stemmer ◽

Seema Biswas

Keyword(s):

Hepatocellular Carcinoma ◽

Operative Procedure ◽

Portal Vein Ligation ◽

Liver Malignancy ◽

Liver Remnant ◽

First Case ◽

Right Lobe ◽

Surgical Recovery ◽

The Right ◽

Macrovesicular Steatosis

Introduction: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) is a surgical procedure for liver malignancy where the volume of the liver remnant is estimated to be too small. We present the first case of two-stage robotic ALPPS procedure, illustrating the steps and advantages of robotic surgery.Materials and Methods: A 68-year-old man with morbid obesity (BMI 40), portal fibrosis, macrovesicular steatosis, and poor liver function underwent robotic ALPPS for hepatocellular carcinoma in the right lobe of the liver (segments 5, 7, and 8). A video presentation (https://youtu.be/M50Gumf-4pw) of the operative procedure is accompanied by explanation in the text with embedded corresponding video time points.Results: Both stages of the procedure were performed robotically, with negligible blood loss, and rapid surgical recovery. The patient died 3 years later.Discussion: Robotic ALPPS offers reduced morbidity in major liver surgery for malignancy and may extend survival in meticulously selected patients.

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Immunohistochemical detection of procalcitonin in fibrolamellar hepatocellular carcinoma

Clinical Journal of Gastroenterology ◽

10.1007/s12328-021-01354-1 ◽

2021 ◽

Author(s):

Kotaro Matsumoto ◽

Kentaro Kikuchi ◽

Ayako Hara ◽

Hiromichi Tsunashima ◽

Koichi Tsuneyama ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Histopathological Examination ◽

Epigastric Pain ◽

Positive Staining ◽

C Reactive Protein ◽

Fibrolamellar Hepatocellular Carcinoma ◽

Tumor Biopsy ◽

Reactive Protein ◽

Right Lobe ◽

The Right

AbstractA 25-year-old woman with fever and epigastric pain was referred to our hospital. Blood examination showed significant liver dysfunction, markedly high C-reactive protein (CRP 19.1 mg/dL) and procalcitonin (48.3 ng/mL) levels. Dynamic computed tomography showed a tumor approximately 120 mm in size in the right lobe of the liver, but with no abscess formation. The patient was hospitalized and started on antibiotics; her CRP level improved, but the procalcitonin level did not decrease. Histopathological examination of the liver tumor biopsy revealed fibrolamellar hepatocellular carcinoma (FLC). Positive staining of the FLC with an anti-procalcitonin antibody suggested the production of procalcitonin.

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Transarterial Radioembolization Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

10.47363/jonrr/2021(2)139 ◽

2021 ◽

pp. 1-4

Author(s):

Kabalane Yammine ◽

◽

Sarah Khalife ◽

Keyword(s):

Hepatocellular Carcinoma ◽

Inferior Vena Cava ◽

Right Atrium ◽

Tumor Thrombus ◽

Inferior Vena ◽

Vena Cava ◽

Treatment Strategies ◽

Complete Response ◽

Advanced Hepatocellular Carcinoma ◽

The Right

Tumor thrombus infiltration of hepatocellular carcinoma (HCC) into the inferior vena cava and right atrium is rare and is associated with a poor prognosis due to the critical location of the tumor and the limited efficiency of the available treatment strategies. In this study, we report the case of a patient with advanced HCC and tumor thrombus in the inferior vena cava and right atrium who demonstrated complete response with mass retraction upon Yttrium-90 trans-arterial radioembolization (90Y- TARE) therapy. Throughout the 16 months follow-ups after the radioembolization, the patient was free of any complications, revealing no occurrence of radiation-induced pneumonitis or tumor recurrence.

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Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

Journal of Oncology ◽

10.1155/2010/635984 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Luca Giovanella ◽

Fabrizio Fasolini ◽

Sergio Suriano ◽

Luca Mazzucchelli

Keyword(s):

Thyroid Carcinoma ◽

Follicular Thyroid Carcinoma ◽

Histopathological Examination ◽

Thyroid Tissue ◽

Follicular Carcinoma ◽

First Case ◽

Right Lobe ◽

Rare Malignancy ◽

The Right ◽

Trabecular Carcinoma

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the -pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

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Contribution of Superior Mesenteric Vein Flow to the Right and Left Lobes of the Liver Using CFD

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-206254 ◽

2009 ◽

Author(s):

Stephanie M. George ◽

Diego R. Martin ◽

Don P. Giddens

Keyword(s):

Portal Vein ◽

Superior Mesenteric Vein ◽

Splenic Vein ◽

Normal Subjects ◽

Diagnostic Techniques ◽

Mesenteric Vein ◽

Right Lobe ◽

Computational Fluid Dynamics Cfd ◽

The Right ◽

End Stage

The incidence of cirrhosis, the end stage for many liver diseases, is rising and with it the need for better understanding of the progression of the disease and diagnostic techniques. The authors have noted that liver disease occurs preferentially in the right side of the liver which is the largest lobe. One hypothesis is that this is due to the composition of the blood that supplies the right lobe. The liver is fed by both the hepatic artery and the portal vein with the portal vein contributing about 80% of the blood supply. The portal vein (PV) is supplied by the superior mesenteric vein (SMV), which drains blood from the digestive track, and the splenic vein (SV), which drains blood from the spleen. Since the blood in the SMV is coming from the digestive track, it carries toxins and items absorbed during digestion. Toxins such as alcohol are known to damage the liver. Thus, our hypothesis is that the majority of the SMV flow feeds into the right portal vein and ultimately the right lobe of the liver. This study seeks to assess the validity of our hypothesis in four subjects by creating subject specific models in two normal subjects and two patients and using computational fluid dynamics (CFD) to calculate the SMV contribution to the right portal vein.

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Living donor liver transplantation of the right lobe for hepatocellular carcinoma in cirrhosis in a European center

Liver Transplantation ◽

10.1002/lt.21189 ◽

2007 ◽

Vol 13 (6) ◽

pp. 896-903 ◽

Cited By ~ 30

Author(s):

Sven Jonas ◽

Jens Mittler ◽

Andreas Pascher ◽

Guido Schumacher ◽

Tom Theruvath ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Right Lobe ◽

The Right

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Renal pelvis metastasis from lung cancer with extension of renal venous thrombus: a case report and literature review

10.21203/rs.3.rs-56047/v1 ◽

2020 ◽

Author(s):

Shengjiang Bai ◽

Li Lai ◽

Ming Shi ◽

Hang Xu ◽

Haoran Lei ◽

...

Keyword(s):

Lung Cancer ◽

Renal Pelvis ◽

Nsclc Patient ◽

Left Lung ◽

Treatment Strategies ◽

Venous Invasion ◽

Metastatic Carcinoma ◽

Venous Thrombus ◽

First Case ◽

The Right

Abstract Background Non-Small Cell Lung Cancer (NSCLC) rarely metastases to the renal pelvis, especially with renal venous tumor thrombus, we presented the first case of a NSCLC patient with renal pelvis metastasis and renal venous invasion.Case presentation A 50-year-old man was referred to the thoracic facility after experiencing a healthy examination revealing solitary pulmonary mass in the left lung, he received surgery of left upper lobe resection and hilar and mediastinal lymph nodes dissection at our hospital in June 2016. Postoperative histopathologic diagnosis was NSCLC (pT3N0M0), and regular follow-up was performed after operation. After eighteen months, he was referred to the urology facility complaining of visible hematuria and pain in the right waist. Abdominal enhanced computed tomography (CT) indicated a neoplasm in the right renal pelvis, and filling coloboma could be seen in the right renal vein during the CT enhancement period. Simultaneously two nodules were found in his right lung. He received radical nephrectomy (RN) for the right kidney and removal of renal venous thrombus in December 2017. The neoplasm occupying the right pelvis and the solid ingredient occupying the right renal venous lumen were histologically considered as a metastatic carcinoma from the NSCLC. Icotinib Hydrochloride Tablets were adminstrated to treat nodules in the right lung since the RN. According to the last re-examination in March 2020, the efficacy was evaluated as partial remission.Conclusions Renal venous invasion of renal tumor not only occurs in renal cell carcinoma (RCC) and upper urinary tract urothelial carcinoma (UTUC), but also can be seen in the state of metastasis. Acquiring correct preoperative diagnosis is of great importance in determining proper treatment strategies. Besides, the aggressive RN for patients suffering advanced metastatic carcinoma of renal pelvis is safe under perfect perioperative management and favorable to treat metastatic carcinoma in other sites.

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The first case of papillary thyroid carcinoma in an adolescent with congenital dyshormonogenetic hypothyroidism in Serbia

Vojnosanitetski pregled ◽

10.2298/vsp1411078e ◽

2014 ◽

Vol 71 (11) ◽

pp. 1078-1080 ◽

Cited By ~ 2

Author(s):

Jelena Eremija ◽

Tatjana Milenkovic ◽

Katarina Mitrovic ◽

Sladjana Todorovic ◽

Rade Vukovic ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

Pathological Examination ◽

Pediatric Malignancy ◽

First Case ◽

Thyroid Papillary ◽

Right Lobe ◽

The Right

Introduction. Differentiated thyroid carcinoma (DTC) is a rare childhood malignancy, as it represents 0.3-0.4% of pediatric malignancies. Papillary carcinoma is the most common type of pediatric DTC and it represents about 90% of all DTC patients. Although rare, DTC arising from dyshormonogenetic goiter is the most serious complication of congenital hypothyroidism. Case report. We presented the development of thyroid papillary carcinoma in a 15-year-old girl diagnosed with congenital dyshormonogenetic hypothyroidism at neonatal age. Considering the early initiation and proper dosage of hormonal substitution, normal levels of thyreotropin and thyroid hormones were achieved quickly and maintained through a follow-up period. The girl remained euthyroid and asymptomatic until 13.8 years of age, when she presented with a large multinodular goiter. The patient underwent total thyroidectomy. Pathological examination revealed intrathyroid microcarcinoma in the right lobe. Conclusion. Although differentiated thyroid carcinoma is a rare pediatric malignancy, it is of great importance to have a certain degree of clinical caution and provide a multidisciplinary approach during the follow-up of patients with dyshormonogenetic hypothyroidism.

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Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00657-0 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Piero Boraschi ◽

Francesca Turini ◽

Francescamaria Donati ◽

Francesca Peruzzi ◽

Annamaria Bartolucci ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Broad Ligament ◽

Cirrhotic Liver ◽

Arterial Phase ◽

Histopathological Diagnosis ◽

Adrenal Rest Tumor ◽

Right Lobe ◽

Adrenal Rest ◽

The Right

Abstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest tumor poses a diagnostic challenge in differentiating it from hepatocellular carcinoma, particularly in a cirrhotic liver. Case presentation An 83-years-old male was referred to our hospital by his family doctor for hepatological evaluation due to multifactorial liver cirrhosis. Ultrasound revealed a centimetric hypoechoic nodule in the VI hepatic segment in the context of a liver with signs of cirrhosis and steatosis. The patient first underwent MRI and then CT, which showed a fat containing focal liver lesion in the subcapsular location of the right lobe, strictly adjacent to the homolateral adrenal gland. The nodule was hypervascular in the arterial phase, washed out in the portal-venous and transitional phases, resulting hypointense in the hepato-biliary phase at MR imaging. In the suspicion of a hepatocellular carcinoma, the nodule was surgically removed, and the patient’s postoperative course was unremarkable. The final histopathological diagnosis was of adrenal rest tumor of the liver. Conclusions Hepatic adrenal rest tumor is an extremely rare hepatic tumor, often without any clinical manifestation, that can also occur in the cirrhotic liver as in our case. Although there are not specific imaging findings, the possible diagnosis of HART should be considered when we observe a well-defined lesion in the subcapsular location of the right lobe, with fat containing, hypervascularity after contrast medium injection and vascular supply from the right hepatic artery.

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Leiomyosarcoma of the right ventricle extending into the pulmonary trunk

Heart ◽

10.1136/hrt.86.1.e2 ◽

2001 ◽

Vol 86 (1) ◽

pp. e2-e2

Author(s):

W Willaert ◽

P Claessens ◽

M Vanderheyden

Keyword(s):

Right Ventricle ◽

Survival Rates ◽

Treatment Strategies ◽

Diagnostic Techniques ◽

Outflow Obstruction ◽

Pathological Analysis ◽

High Relapse Rate ◽

Complete Surgical Resection ◽

High Mitotic Activity ◽

The Right

Primary leiomyosarcomas of the heart, particularly those affecting the right ventricle, are uncommon. A 70 year old woman presenting with the symptoms of progressive exertional dyspnoea and left sided pleuritic pain is presented. A leiomyosarcoma was diagnosed that originated in the right lateral ventricle wall, causing pulmonary outflow obstruction. Pathological analysis showed a neoplasm with a myxoid stroma, high mitotic activity, and nuclei expressing atypia. Immunohistochemical staining was found positive for vimentin and desmin. Seven months after complete surgical resection the tumour relapsed. This case illustrates the poor outcome, high relapse rate, and inefficiency of treatment associated with primary cardiac leiomyosarcomas. The current literature regarding incidence, diagnostic techniques, treatment strategies, and survival rates of this rare but terminal disease is reviewed.

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