ABSTRACT
Pancreatic hepatoid carcinoma (PHC) is a rare neoplasm that shares differentiation features with hepatocellular carcinoma. It is a special type of adenocarcinoma which can be accompanied by elevated serum AFP. PHC is highly invasive, and has a poor prognosis, and it usually present with vascular invasion, liver and/or lymph node metastasis. Preoperative diagnosis of PHC is difficult, and there is currently no consensus on its diagnosis and treatment. A better understanding of PHC is helpful to improve its diagnostic rate and to allow timely and effective application of treatment. This article reviews the research progress on PHC.
ABSTRACT
Hepatoid adenocarcinoma of the lung is a rare subtype of lung cancer. We report a case of a metastatic hepatoid adenocarcinoma of the lung with aggressive behavior, including biopsy and autopsy findings. The pulmonary tumors showed features indistinguishable from hepatocellular carcinoma and were diffusely positive for Hepatocyte Paraffin 1.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma , Carcinoma, Non-Small-Cell Lung , Carcinoma, Hepatocellular , Lung Neoplasms , Autopsy , Fatal OutcomeABSTRACT
@#Alpha-fetoprotein (AFP)-producing carcinoma which microscopically mimics hepatocellular carcinoma (HCC) is a rare entity known as hepatoid adenocarcinoma (HC). They usually arise in the stomach, while oesophageal origin is only occasionally encountered. This tumour is highly aggressive and is associated with a poor prognosis. They frequently metastasise to the liver, thus giving rise to diagnostic difficulty, especially in cases where simultaneous oesophageal and liver mass are present. We reported a case of oesophageal hepatoid carcinoma with multiple liver metastasis, that was associated with an increased serum AFP. The distinction between HCC and HC is important because HC is more aggressive and has a poorer prognosis with limited therapeutic options. An extensive diagnostic work-up which include a thorough clinical history, radiological investigations (computed tomography or magnetic resonance imaging) as well as tissue biopsy supported by a panel of immunohistochemical markers are necessary to aid in the diagnosis of HC.
ABSTRACT
Hepatoid carcinoma is extrahepatic neoplasm showing similar morphologic, immunohistochemical features with hepatocellular carcinoma. It's a very rare disease and has been reported most frequently in the stomach. Herein, we report a case of hepatoid carcinoma of pancreas presented with acute pancreatitis. The hepatoid carcinoma was diagnosed by his needle biopsy specimen and it showed pleomorphic nuclei and predominantly eosinophilic and occasionally clear cytoplasm in hematoxylin and eosin staining, and positive for HepPar-1 and cytokeratin 19 in immunohistochemical staining. Surgical treatment seems to be the best choice, if possible. However, there is no standard regimen for palliative chemotherapy. In our case, the patient was treated with 5-Fluorouracil (5-FU), folinic acid, irinotecan, oxaliplatin (FOLFIRINOX). The response was stable disease up to 4 month of follow up.
Subject(s)
Humans , Biopsy, Needle , Carcinoma, Hepatocellular , Cytoplasm , Drug Therapy , Eosine Yellowish-(YS) , Eosinophils , Fluorouracil , Follow-Up Studies , Hematoxylin , Keratin-19 , Leucovorin , Pancreas , Pancreatitis , Rare Diseases , StomachABSTRACT
Primary hepatoid carcinoma of the ovary (HCO) is a rare type of ovarian tumor that resembles hepatocellular carcinoma both histologically and immunohistochemically in its staining for alpha-fetoprotein (AFP). We describe a 51-year-old woman who presented to our hospital complaining of abdominal pain. Computed tomography scan revealed a large tumor in the pelvis. She underwent total hysterectomy and bilateral salpingo-oophorectomy with tumorectomy. A right ovarian mass measuring 9x8x6 cm was found. Histological diagnosis was hepatoid carcinoma of the right ovary. But, immunohistochemically, tumor cells were not immunoreactive for AFP and there was no elevation of serum AFP level. This is the first report of an ovarian carcinoma with typical histologic features of HCO with negative staining for AFP and normal level of serum AFP in the world.
Subject(s)
Female , Humans , Abdominal Pain , alpha-Fetoproteins , Carcinoma, Hepatocellular , Hysterectomy , Negative Staining , Ovary , PelvisABSTRACT
We report herein a case of gastric undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. A 57-year-old man was referred after a gastroscopy for anemia evaluation. Gastroscopy revealed an approximately 3 cm ulcerofungating mass occupying the greater curvature of stomach body. Biopsy results revealed a poorly differentiated adenocarcinoma. Left gastric lymph node was enlarged, but there were no evidence of distant metastasis on the abdominal CT. He underwent a radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. Immunohistochemical staining revealed that the tumor cells were focal positive for AFP, anti-hepatocyte antibody.
Subject(s)
Adenocarcinoma , Anemia , Biopsy , Carcinoma , Endodermal Sinus Tumor , Gastrectomy , Gastroscopy , Lymph Nodes , Neoplasm Metastasis , Stomach , Yolk SacABSTRACT
Here we report a case of a patient with gastric undifferentiated carcinoma associated with choriocarcinomatous and hepatoid carcinomatous differentiation. A 62-year-old man was referred after a healthcare screening gastroscopy. Gastroscopy revealed an approximately 3x3 cm ulcerofungating mass in the posterior wall of the antrum. Biopsy results revealed a moderately differentiated adenocarcinoma. The initial serum alpha-FP levels were above 350 ng/mL. An abdominal CT scan revealed focal wall thickening along the greater curvature of the gastric antrum, with perigastric fat invasion and enlarged multiple perigastric lymph nodes. He underwent a palliative radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma associated with choriocarcinomatous and hepatoid carcinomatous differentiation. Immunohistochemical staining revealed that the tumor cells were positive for human chorionic gonadotropin (hCG), alpha-FP, and anti-hepatocyte antibody.
Subject(s)
Female , Humans , Middle Aged , Pregnancy , Adenocarcinoma , Biopsy , Carcinoma , Choriocarcinoma , Chorionic Gonadotropin , Delivery of Health Care , Gastrectomy , Gastroscopy , Lymph Nodes , Mass Screening , Pyloric AntrumABSTRACT
Hepatoid carcinoma is a primary extrahepatic carcinoma whose morphology, immunohistochemistry, and behavior are similar to those of hepatocellular carcinoma. The most common sites of extrahepatic carcinoma are the stomach and ovary, but nine cases of hepatocellular differentiation of the pancreas have been reported in the literature. We report another case of hepatoid carcinoma of the pancreas that was associated with the development of a pancreatic endocrine carcinoma in a 46-year-old man. Serum alpha-fetoprotein (AFP) was elevated to 262.49 IU/mL and radiological examinations revealed a mass measuring 7.5 cm in diameter in the head of the pancreas. He underwent a conventional Whipple operation, and light microscopy showed adenocarcinoma that was immunopositive for AFP, hepatocyte antigen, cytokeratin, chromogranin, synaptophysin, and alpha-1 antichymotrypsin. Although hepatoid differentiation was not shown unequivocally histologically, other immunohistochemistry findings supported the diagnosis of hepatoid carcinoma combined with neuroendocrine carcinoma. The patient was healthy and had no evidence of recurrence at 4 months after the surgery. This report describes why hepatoid carcinoma should be considered as a differential diagnosis of a pancreatic mass, especially when serum AFP is elevated.
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , alpha-Fetoproteins , Carcinoma, Hepatocellular , Carcinoma, Neuroendocrine , Diagnosis, Differential , Head , Hepatocytes , Immunohistochemistry , Keratins , Light , Microscopy , Ovary , Pancreas , Recurrence , Stomach , SynaptophysinABSTRACT
Hepatoid carcinoma is a primary extrahepatic neoplasm exhibiting features of hepatocellular carcinoma (HCC) in terms of morphology, immunohistochemistry, and behavior. In many cases, tumor cytoplasm is positive for alpha- fetoprotein (alpha-FP) with elevated serum alpha-FP level. Because not all hepatoid carcinomas are associated with alpha- FP overproduction, diagnosis should be made essentially by histological features of the tumor. We present a case of hepatoid carcinoma of the pancreas in a 21-year-old male patient. Abdominal computed tomography and magnetic resonance imaging revealed an inhomogeneously enhanced pancreatic head mass. Serum alpha-FP level was markedly elevated. He underwent pylorus-preserving Whipple's operation. The tumor showed hepatoid and neuroendocrine components simultaneously. The histopathological diagnosis was hepatoid carcinoma associated with neuroendocrine tumor of the pancreas. Seven months after the surgery, the patient is healthy without evidence of recurrence. To date, only 7 cases of hepatoid carcinoma of the pancreas have been reported in the literature, and this is the first case report in Korea.
Subject(s)
Adult , Humans , Male , Carcinoma, Hepatocellular/pathology , Pancreatic Neoplasms/diagnosisABSTRACT
Hepatoid carcinoma is histologically similar to hepatocelluar carcinoma and produce alfa-fetoprotein. Ovarian hepatoid carcinoma is extremely rare whether primary or metastatic. We experienced one case of primary ovarian hepatoid carcinoma. In this case report, we present histologic findings, therapeutic modalities of primary hepatoid carcinoma with review of literatures.
Subject(s)
Female , alpha-Fetoproteins , OvaryABSTRACT
Hepatoid carcinoma is a rare type of malignant tumor resembling hepatocellular carcinoma that arises in extrahepatic sites.(stomach, lung, ovary, pancreas, bladder and renal pelvis). Hepatoid carcinoma of the ovary is an extremely rare ovarian tumor, first described by Ishikura and Scully in 1987. Histologically it is important to differentiate this entity from other oxyphil tumors of the ovary as it requires aggressive treatment. We have experienced a case of hepatoid carcinoma of the ovary in 69-year-old postmenopausal woman, who has been treated with operation and adjuvant Taxol - cisplatin chemotherapy. We present this case with brief review of literatures.
Subject(s)
Aged , Female , Humans , Carcinoma, Hepatocellular , Cisplatin , Drug Therapy , Lung , Ovary , Paclitaxel , Pancreas , Urinary BladderABSTRACT
Hepatoid carcinoma is a rare type of malignant tumor resembling hepatocellular carcinoma that arises in extrahepatic sites.(stomach, lung, ovary, pancreas, bladder and renal pelvis). Hepatoid carcinoma of the ovary is an extremely rare ovarian tumor, first described by Ishikura and Scully in 1987. Histologically it is important to differentiate this entity from other oxyphil tumors of the ovary as it requires aggressive treatment. We have experienced a case of hepatoid carcinoma of the ovary in 69-year-old postmenopausal woman, who has been treated with operation and adjuvant Taxol - cisplatin chemotherapy. We present this case with brief review of literatures.
Subject(s)
Aged , Female , Humans , Pregnancy , Carcinoma, Hepatocellular , Cisplatin , Drug Therapy , Lung , Ovary , Paclitaxel , Pancreas , Primary Ovarian Insufficiency , Urinary BladderABSTRACT
A 56-year-old man received subtotal gastrectomy for an early gastric carcinoma type IIa+IIc with submucosal invasion. The tumor was made up of mixed papillo-tubular adenocarcinoma and solid carcinomatous portion, the latter comprising approximately four-fifths of the total tumor mass. The solid portion was confined within the submucosa and revealed a mixture of trabecular, compact and pelioid patterns of large polyhedra cells, resembling hepatocellular carcinoma of the liver(Edmondson-Steiner grade 2). Sinusoid-like vascular stroma of classical trabecular hepatocellular carcinoma intervened the tumor cell nests but was not associated with endothelial-cell lining. Immunohistochemical stainings with alpha-fetoprotein and alpha1-antitrypsin gave a strong reactivity in those areas of hepatoid differentiation and in the adjacent minute portion of adenocarcinoma. The findings suggest that a portion of gastric carcinoma may transdifferentiate into cells with hepatoid features along the line of endodermal lineage.