Abstract
The majority of neuroendocrine tumors appear to be sporadic. Neuroendocrine carcinoma (NEC) typically arises in pancreatic, parathyroid and adrenal glands, but rarely arises in salivary glands. NEC of the tonsil is a rare type of tumor and the concurrent presentation of hepatocellular carcinoma (HCC) is considered to be more uncommon. There are few case reports of NEC of the tonsil in the literature and to date no studies have been conducted to establish its optimal management. The current study presents a case of a 72-year-old male who presented with left neck and tonsil tumors. A biopsy from the tonsil revealed a NEC, and computed tomography showed liver cirrhosis, multiple liver cancers and portal vein thrombosis, as well as metastasis to the hilar, abdomen and retroperitoneum. Histological examination of the hepatic revealed primary HCC. To the best of our knowledge, this is a condition that has not previously been reported.
Highlights
It is hypothesized that neuroendocrine carcinoma (NEC) arise from cells that are involved in the diffuse endocrine system [1]
NEC are a heterogeneous family of neoplasms that possess a broad spectrum of types of histomorphology, tissue origins and clinical behaviors [7]
NEC generally exhibit slow growth, prognosis is dependent on the tumor site, histological type, degree of differentiation, mitotic rate, Ki‐67 proliferative index, tumor size, depth, location and the presence of lymph node or liver metastases [8]
Summary
Fine‐needle aspiration of the left tonsil mass had been performed at two other hospitals and was identified to be positive for a small‐cell malignancy or NEC. The patient was referred to The Affiliated Tumor Hospital of Guangzhou Medical University (Guangzhou, China) for further treatment. Various tumors located in the right hepatic posterior lobe and right adrenal gland were identified by color Doppler ultrasound. The largest liver tumor measured 3.3x3.1 cm and was located in the right lobe. The patient was diagnosed with NEC of the right tonsil with metastatic disease to the neck, a poorly differentiated HCC, right adrenal metastatic tumor and level 3 hypertension, and was considered to be at a high‐risk stage. The patient abandoned the treatment and succumbed due to asphyxia two days after leaving The Cancer Center of Guangzhou Medical University (Guangzhou, China)
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