Background Hepatic inflammatory pseudotumor (IPT) is a rare, benign, tumor-like lesion. Because there are no characteristic laboratory markers or radiological features, hepatic IPT is often misdiagnosed as a malignant neoplasm such as hepatocellular carcinoma (HCC). Case presentation A 68-year-old man with liver dysfunction due to chronic hepatitis C virus infection and alcoholic liver disease presented with hepatic tumors in segments III and VIII. The levels of serum alpha-fetoprotein (AFP) and its Lens culinaris agglutinin-reactive fraction, AFP lectin 3 (AFP-L3), were elevated to 822.8 ng/ml and 75.2%, respectively. The tumor showed contrast enhancement on contrast-enhanced computed tomography and various accumulation on positron emission tomography. Based on these biological and imaging features, HCC was suspected, and we performed laparoscopic partial hepatectomy for these two tumors. Pathological diagnosis revealed that both tumors were hepatic IPTs with no malignant characteristics. After hepatectomy, the serum AFP and AFP-L3 levels decreased to the normal range. Conclusion We report a very rare case of hepatic IPT with elevated serum AFP and AFP-L3, mimicking HCC. Clinicians should include this rare neoplasm in the differential diagnoses of hepatic tumors even when the serum markers for HCC are elevated.

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The treatment outcome of extrahepatic cholangiocarcinoma remains insufficient because it is difficult to obtain accurate diagnosis of tumor spreading and effective treatment agent is quite limited in spite of substantial current efforts, all of which have been unsuccessful except for gemcitabine plus cisplatin. The patient was a 60-year-old female who had developed hilar cholangiocarcinoma and underwent extrahepatic bile duct resection. Although it was conceivable that it would be the R1 resection, the patient wanted to receive limited resection to avoid postoperative complication mainly because she was depressed. In histology, interstitial spreading of tumor was appreciated at the surgical margin of bile duct. The patient did not accept to receive the additional treatment after the surgery and hardly visited the hospital to take the periodical test for monitoring the residual cancer cells. As expected, the local relapse of tumor was appreciated 1 year after the R1 surgery. She chose radiotherapy and agreed with subsequent S-1 treatment for 26 months. Consequently, elevated CA19-9 was decreased, and local relapse has been successfully controlled for more than 7 years after the relapse of tumor. Here, we report quite a rare case in terms of long survivor after chemoradiotherapy on locally relapsed unresectable hilar cholangiocarcinoma.

[Background] Neuroendocrine neoplasms (NEN) developing in the digestive organs are relatively rare tumors, with 3 to 5 new cases per 100,000 population annually, most of which occur in the pancreas and digestive tract. In pancreatic neuroendocrine neoplasms (PNEN), the risk of metastasis and progression varies depending on the grade of the tumor, even when the tumor size is small. In clinical practice, it is often difficult to determine the indication for surgery or multidisciplinary treatment with chemotherapy. The mechanisms of tumor formation and progression in PNEN remain unknown. YAP/TAZ have been known to play an important role in pancreatic development. Here, we explore the biological and clinical significance of YAP/TAZ over-expression in PNEN. [Methods] Immunostaining for YAP/TAZ was performed using 92 resected specimens in PNEN patients, and the association between YAP/TAZ overexpression and clinicopathological factors was elucidated. Furthermore, we generated a PNEN cell line with YAP and TAZ over-expression using QGP-1, and examined the intracellular signals regulated by YAP/TAZ expression. [Results and Discussion] The overexpression of YAP, TAZ, and YAP/TAZ were observed in 55, 55, and 32patients, respectively. High YAP expression was significantly associated with positive lymphovascular invasion (p=0.04). YAP/TAZ-high group displayed significantly worse Overall survival (p=0.0023) and recurrence-free survival (p=0.007) compared to those in others. By Western-blotting, YAP/TAZ overexpression in the QGP-1 cell line enhanced phosphorylation of Akt and Erk1/2. [Conclusions] High expression of YAP/TAZ in PNEN was implicated in poor prognosis, and was also associated with Akt, Erk1/2, and mTOR. Citation Format: Yuta Shiraishi, Hiromitsu Hayashi, Daisuke Ogawa, Shinsei Yumoto, Hiroki Sato, Takashi Matsumoto, Toru Takematsu, Masataka Maruno, Masayo Tsukamoto, Tatsunori Miyata, Shigeki Nakagawa, Kosuke Mima, Hidetoshi Nitta, Hideo Baba. Investigation of the molecular biological significance of YAP/TAZ expression in PNEN [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2239.

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