Computed tomography manifestations and pathological features of neuroendocrine carcinoma in uncommon sites

BACKGROUND: A neuroendocrine carcinoma is a malignant tumor that originates from the diffused neuroendocrine system (DNES). The present study aims to analyze the computed tomography (CT) manifestations and pathological features of neuroendocrine carcinomas in uncommon sites, in order to raise awareness of this disease. METHODS: The CT manifestations and pathological features of 29 cases of neuroendocrine carcinoma (confirmed by pathology) were retrospectively analyzed. The pathological results of these 29 cases were obtained through operations, and all cases underwent preoperative CT plain scanning and dynamic enhanced scanning. RESULTS: The neuroendocrine carcinoma sites were: the breast (five cases), the cervix (nine cases), the uterine body (one case), the gallbladder (two cases), the mediastinum (five cases), the pyelobladder (one case), the kidneys (one case), the bladder (two cases), the liver (one case), the pancreas (one case), and the ovaries (one case). The CT manifestations were as follows. Most of the carcinomas were solid, and in a mode of infiltrative growth. Poorly differentiated neuroendocrine carcinomas had blurred boundaries. Cystic necrosis could be observed in most lesions, and the calcifications were visible in some lesions. Of the 29 cases studied, 23 had moderate (>20 HU and <40 HU) or higher enhancement in the CT scans. Peripheral invasion, bone destruction and distant metastasis were more likely to be seen in these lesions. CONCLUSIONS: The imaging manifestations of neuroendocrine carcinoma varies in uncommon sites. It would therefore be helpful to understand the diversity and imaging signs of neuroendocrine carcinoma, in order to improve diagnosis.