Comprehensive treatment for two patients with small cell neuroendocrine carcinoma of the liver: A case report and literature review

Hepatic small cell neuroendocrine carcinoma (HSCNEC) is a rare and aggressive malignancy with a poor prognosis. The marked heterogeneity of neuroendocrine carcinomas, along with their predominantly non‑functional nature and the absence of specific biomarkers, poses substantial diagnostic challenges and leads to complex, varied treatment pathways. Owing to its rarity and the scarcity of clinical evidence, treatment options for HSCNEC remain limited, often resulting in unsatisfactory outcomes. Recent advances, however, underscore transcatheter arterial chemoembolization (TACE) combined with targeted immunotherapy as a promising strategy for HSCNEC. A 76‑year‑old male patient was admitted for intermittent right upper abdominal pain lasting 3 months. Medical history included hepatitis B for 50 years, hypertension for 20 years, diabetes mellitus for 10 years and coronary artery disease for 5 years. A 58‑year‑old male was admitted to the hospital one week after discovering a hepatic space‑occupying lesion, following 1 month of upper abdominal discomfort. The patient had a history of hepatitis B for >10 years. Both patients underwent tumor puncture biopsy and the pathological diagnosis confirmed the presence of SCNEC of the liver. The first patient received TACE but declined subsequent combined targeted immunotherapy and died 3 months later. By contrast, the second patient underwent multiple sessions of TACE along with targeted immunotherapy, resulting in a significant improvement in quality of life. This patient is currently under regular follow‑up and is able to lead a normal life and work. HSCNEC is a rare type of intrahepatic neuroendocrine tumor. For cases that are not amenable to surgical resection, TACE combined with targeted immunotherapy may be considered. This comprehensive treatment approach can significantly enhance the effectiveness of therapy and prolong overall survival for patients.