Metastatic hepatocellular carcinoma presenting as a pancreatic mass by computed tomography scan and mimicking a primary neuroendocrine tumor: A potential pitfall in aspiration cytology

Valerie A. Fitzhugh, Stacey A. Kim, Anthony Borcich, Hongfa Zhu, Maoxin Wu, Arnold H. Szporn, Hua Chen

Research output: Contribution to journalArticle

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Hepatocellular carcinoma (HCC) is a highly malignant neoplasm, often presenting at late stage and portending a poor prognosis for the patient. The peripancreatic fat is a rare site of extrahepatic metastasis, and metastatic HCC can mimic primary pancreatic neoplasms, even in this location. It is crucial to be aware of this pitfall in the evaluation of aspiration cytology of pancreatic neoplasms and to develop a strategy to reach the correct diagnosis. We present an endoscopic ultrasound fineneedle aspiration diagnosis of metastatic HCC presenting as a pancreatic mass radiologically that had neuroendocrine features on various cytological and histological preparations. The metastatic lesions were located surgically in the peripancreatic adipose tissue with involvement of one peripancreatic lymph node. This case illustrates the utility of FNA for diagnosing uncommon presentations of HCC and the importance of clinical history, cell block, and an immunocytochemical panel in determining the origin of the tumor.

Original languageEnglish (US)
Pages (from-to)915-919
Number of pages5
JournalDiagnostic Cytopathology
Issue number12
Publication statusPublished - Dec 22 2009



  • Endoscopic ultrasound-guided fine-needle aspiration
  • Hepatocellular carcinoma
  • Metastasis
  • Neuroendocrine tumor
  • Pancreas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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