Calcifying nested stromal epithelial tumor of the liver in a patient with Klinefelter syndrome: a case report and review of the literature

World J Surg Oncol. 2018 Nov 19;16(1):227. doi: 10.1186/s12957-018-1528-x.

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: Calcifying nested stromal epithelial tumor (CNSET); Hormone imbalance; Klinefelter syndrome; Liver; Neoplasm.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Calcinosis / complications
  • Calcinosis / pathology*
  • Calcinosis / therapy
  • Combined Modality Therapy
  • Embolization, Therapeutic
  • Epithelial Cells / pathology*
  • Fatal Outcome
  • Hepatectomy
  • Humans
  • Klinefelter Syndrome / complications
  • Klinefelter Syndrome / pathology*
  • Klinefelter Syndrome / therapy
  • Liver Neoplasms / complications
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / therapy
  • Lymphatic Metastasis
  • Male
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / therapy
  • Neoplasms, Complex and Mixed / complications
  • Neoplasms, Complex and Mixed / pathology*
  • Neoplasms, Complex and Mixed / therapy
  • Stromal Cells / pathology*
  • Young Adult