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Tumour to tumour metastasis: case of a carotid body paraganglioma metastatic to a hepatocellular adenoma
  1. Nicole Jedrzejko1,
  2. Kyra B Berg2,
  3. Ananta Gurung2 and
  4. Shawn MacKenzie1
  1. 1Surgery, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Nicole Jedrzejko; nicole.jedrzejko{at}alumni.ubc.ca

Abstract

Tumour to tumour metastases are uncommon, and we report a case of carotid body paraganglioma metastatic to a hepatocellular adenoma. A 54-year-old man presented after a CT chest for chronic cough that incidentally identified two liver lesions in segment 3 and caudate. The imaging findings were suspicious for atypical haemangiomas versus hepatocellular adenoma. The segment 3 lesion was biopsied, demonstrating beta-catenin activated hepatocellular adenoma. He underwent partial hepatectomy with pathology showing the beta-catenin activated hepatocellular adenoma contained a central area of paraganglioma. On closer review, the patient revealed a carotid body paraganglioma with lymph node metastases requiring resection 24 years earlier. He subsequently underwent left hepatectomy including the resection bed and caudate, which confirmed the caudate lesion as metastatic paraganglioma. This case demonstrates how paraganglioma can metastasise to liver decades after initial resection and provide insight into the diagnostic workup for hepatocellular adenoma with neuroendocrine features.

  • hepatic cancer
  • pathology
  • gastrointestinal surgery
  • general surgery

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Footnotes

  • Twitter @njedrzejko

  • Contributors Patient was under the clinical care of all authors: SM (hepatobiliary surgeon), NJ (general surgery resident), AG (gastrointestinal pathologist) and KBB (anatomic pathology resident). Report was written by NJ as guarantor with KBB writing the pathology section. Report was edited equally by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.