Profile Of Uncommon Primary Adult Hepatic Malignancies At A Tertiary Care Centre

Abstract

Context: Hepatocellular carcinoma has been the most common primary malignancy of the liver in adults, followed by cholangiocarcinoma. The less common malignancies arise from the vascular endothelial cells, neuroendocrine cells, hematolymphoid tissues, and mesenchymal tissues. Imaging studies alone may pose a diagnostic challenge due to variable appearances. Histological review of the tissue specimen, along with immunohistochemical stains is imperative for diagnosis. However, a multidisciplinary approach is necessary to make an accurate diagnosis and help in management. Out of the 24 liver malignancies encountered, six unusual primary malignancies were seen. Radiologic impression and biochemical parameters helped arrive at a definitive opinion as the lesions were not typical of this location. A high index of suspicion along with the immunohistochemical profile finally facilitated the diagnosis.

Aims: To study unusual adult primary hepatic malignancies in a 2-year study period with clinic-radiological and biochemical correlation and also determine the age and sex distribution.

Methods and Material: This study was performed in 2 years in the Department of Pathology. Ethics approval was obtained. A total of 24 liver malignancies were encountered. Metastatic tumors and tumor-like lesions were excluded. The patient's clinico-radiological findings and laboratory investigations were noted. A total of 6 unusual non-hepatocellular malignancies were seen and identified based on morphology and special stains. Statistical analysis used: SPSS version 23.0.

Results: Out of 6 non-hepatocellular malignancies, 3 were neuroendocrine carcinomas, 2 were leiomyosarcomas and 1 was a hematolymphoid malignancy.

Conclusion: The cases of primary non-hepatocellular malignancies are unexpected. A multidiciplinary approach is mandatory.