Primary Hepatic Neuroendocrine Carcinoma with Thrombocytopenia Due to Diffuse Bone Marrow and Splenic Infiltration: An Autopsy Case

An 82-year-old man with fever and back pain was referred to our hospital and was thus found to be thrombocytopenic. A bone marrow biopsy revealed the diffuse infiltration of poorly differentiated neuroendo-crine carcinoma (NEC). Computed tomography revealed a large hepatic mass. Considering the risk of bleed-ing due to thrombocytopenia, a needle biopsy was not performed. The patient rapidly deteriorated and died 10 days after presentation. An autopsy confirmed the diagnosis of primary hepatic NEC, with diffuse metas-tasis to the spleen, bone marrow, and systemic lymph nodes. This is an extremely rare case of NEC present-ing with thrombocytopenia due to extensive bone marrow and splenic infiltration.