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Radiological imaging showed arterially enhancing liver and pancreatic lesions leading to clinical suspicion of non-functional pancreatic neuroendocrine tumour with neuroendocrine liver metastases in non-cirrhotic liver. Histopathological examination with immunohistochemistry following left lateral hepatectomy with pancreaticoduodenectomy and lymphadenectomy showed FL-HCC with lymph nodal metastases involving intrapancreatic lymph node and station 7, 8 lymph nodes. The patient had an uneventful postsurgical recovery and was kept under close follow-up. FL-HCC with nodal metastasis involving intrapancreatic lymph node is an unusual phenomenon and a challenging clinicopathological diagnosis<\/jats:p>","DOI":"10.1136\/bcr-2024-262872","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T01:30:31Z","timestamp":1735867831000},"page":"e262872","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fibrolamellar hepatocellular carcinoma with intrapancreatic nodal metastases masquerading as pancreatic neuroendocrine tumour with hepatic metastases"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3415-1715","authenticated-orcid":false,"given":"Sree Vani","family":"Paladugu","sequence":"first","affiliation":[{"name":"General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niladri Mohan","family":"Raypattanaik","sequence":"additional","affiliation":[{"name":"General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5520-8306","authenticated-orcid":false,"given":"Suvradeep","family":"Mitra","sequence":"additional","affiliation":[{"name":"Histopathology, PGIMER, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1837-2614","authenticated-orcid":false,"given":"Lileswar","family":"Kaman","sequence":"additional","affiliation":[{"name":"General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"2025082700262160000_18.1.e262872.1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.2214\/AJR.21.26982","article-title":"Variant Hepatocellular Carcinoma Subtypes According to the 2019 WHO Classification: An Imaging-Focused Review","volume":"219","author":"Loy","year":"2022","journal-title":"AJR Am J Roentgenol"},{"key":"2025082700262160000_18.1.e262872.2","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-016-0903-8"},{"key":"2025082700262160000_18.1.e262872.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-023-05621-z"},{"key":"2025082700262160000_18.1.e262872.4","doi-asserted-by":"crossref","first-page":"745","DOI":"10.2147\/JHC.S406902","article-title":"Current Advances in the Treatment of Fibrolamellar Carcinoma of Liver","volume":"10","author":"Gummadi","year":"2023","journal-title":"J Hepatocell Carcinoma"},{"key":"2025082700262160000_18.1.e262872.5","first-page":"196","article-title":"The Role of Immunocytochemical Markers to Differentiate Primary from Secondary Neoplastic Hepatic Masses: A Diagnostic Challenge on Cytology","volume":"37","author":"Bhattacharya","year":"2021","journal-title":"Turk Patoloji Derg"},{"key":"2025082700262160000_18.1.e262872.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.xcrm.2024.101469","article-title":"DNAJB1-PRKACA fusion neoantigens elicit rare endogenous T cell responses that potentiate cell therapy for fibrolamellar carcinoma","volume":"5","author":"Kirk","year":"2024","journal-title":"Cell Rep Med"},{"key":"2025082700262160000_18.1.e262872.7","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510260412"},{"key":"2025082700262160000_18.1.e262872.8","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3181984f7f"},{"key":"2025082700262160000_18.1.e262872.9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12957-020-01855-2","article-title":"Clinical features and surgical outcomes of fibrolamellar hepatocellular carcinoma: retrospective analysis of a single-center experience","volume":"18","author":"Lemekhova","year":"2020","journal-title":"World J Surg Oncol"},{"key":"2025082700262160000_18.1.e262872.10","first-page":"53","article-title":"Il carcinoma hepatico fibrolamellare. 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