Abstract

Hepatocellular carcinoma is a common subtype of primary liver malignancy, in addition to cells with hepatic differentiation. It can rarely contain additional cell populations such as neuroendocrine carcinoma (NEC) or cholangiocarcinoma. Mixed hepatocellular carcinoma – neuroendocrine carcinoma (HCC-NEC) are extremely rare tumours, constituting about 0.40% of all primary hepatic malignancies. Most of them are incidentally diagnosed after surgical resection of liver and have a very aggressive behaviour. Very few cases have been reported worldwide.
We hereby present a unique case of HCC–NEC in an elderly male, the patient presenting to us as a soft tissue mass in paraspinal region which revealed a metastatic lesion from a primary hepatic HCC–NEC tumour, only after undergoing investigations. Ours is probably the first case in literature where a primary HCC-NEC has presented as a metastatic soft tissue deposit. Inspite of multimodalities of treatment like surgical resection and chemotherapy, the prognosis in such cases remains extremely poor.