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Calcifying nested stromal epithelial tumor of the liver in a patient with Klinefelter syndrome: a case report and review of the literature
Authors:Satoru Tsuruta  Norihisa Kimura  Keinosuke Ishido  Daisuke Kudo  Kentaro Sato  Tetsu Endo  Tadashi Yoshizawa  Aoi Sukeda  Nobuyoshi Hiraoka  Hiroshi Kijima  Kenichi Hakamada
Institution:1.Department of Gastroenterological Surgery,Hirosaki University Graduate School of Medicine,Hirosaki,Japan;2.Department of Gastroenterology and Hematology,Hirosaki University Graduate School of Medicine,Hirosaki,Japan;3.Department of Pathology and Bioscience,Hirosaki University Graduate School of Medicine,Hirosaki,Japan;4.Division of Pathology and Clinical Laboratories,National Cancer Center Hospital,Tokyo,Japan
Abstract:

Background

Calcifying nested stromal epithelial tumor (CNSET) is a primary neoplasm of the liver, characterized by well-demarcated nests consisting of spindle and epithelioid cells with calcification and bone formation. An association of Cushing syndrome with CNSET has drawn attention, but the origin of CNSET has not been clarified.

Case presentation

We report here the case of a 20-year-old male with Klinefelter syndrome who underwent liver resection for an increasing liver tumor that was pathologically diagnosed with CNSET. He was postoperatively followed up and received several examinations, and recurrences and extrahepatic lymph node metastases were detected on the 64th day after surgery. Chemoembolization and chemotherapy were not effective, leading to tumor progression with development of progressive liver failure, and the patient finally died 164 days after hepatectomy.

Conclusions

This case suggests that an imbalance of hormones affects the genesis and progression of CNSET, and indicates the importance of closely following patients with CNSET by imaging with attention to hepatic recurrence and extrahepatic metastases.
Keywords:
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