Spontaneous regression of advanced hepatocellular carcinoma: a case report.

Spontaneous regression of advanced hepatocellular carcinoma is extremely rare. A 66-year-old Taiwanese male patient with liver cirrhosis related to chronic hepatitis C presented with hepatocellular carcinoma with portal vein thrombosis. At first, he refused curative therapy, except for silymarin medicine. Spontaneous regression of hepatocellular carcinoma occurred with a decline in tumour size and tumour marker in imaging studies. The patient agreed to undergo surgery approximately 14 months after presentation because of no further decrease in tumour size and an increase in tumour marker in the imaging studies. The resected tumour was hepatocellular carcinoma with portal vein thromboses. Presently, the patient is alive and in good condition without any symptoms or tumour recurrence. We concluded that this was a rare case of spontaneous regression of advanced hepatocellular carcinoma.

Hepatoid adenocarcinoma of the stomach with liver metastasis mimicking hepatocellular carcinoma: a case report.

INTRODUCTION: Hepatoid adenocarcinoma is a special type of extrahepatic alpha-fetoprotein-producing adenocarcinoma, which has a morphologic similarity to hepatocellular carcinoma. We report a patient with underlying hepatitis B virus infection and hepatoid adenocarcinoma with liver metastasis mimicking hepatocellular carcinoma. CASE PRESENTATION: We present the case of a 56-year-old Chinese female with underlying hepatitis B virus infection, who was found to have multiple hepatic tumors by abdominal ultrasound and an elevated level of serum alpha-fetoprotein. Hepatocellular carcinoma was considered based on the image findings, the elevated level of serum alpha-fetoprotein. and underlying hepatitis B virus infection. Moreover, the subsequent endoscopy revealed gastric tumor. However, the tumor histology of the stomach and liver revealed glandular adenocarcinoma with hepatoid foci. The final diagnosis is hepatoid adenocarcinoma of the stomach with liver metastasis. CONCLUSION: Hepatoid adenocarcinoma is an aggressive tumor with liver metastasis being the first clinical manifestation of the neoplasm. Hepatoid adenocarcinoma of the stomach with liver metastasis should be considered in older patients with elevated serum alpha-fetoprotein and multiple hepatic tumors with underlying chronic liver disease. An upper gastrointestinal endoscopy should be performed to exclude the possibility of hepatoid adenocarcinoma originating from the stomach to avoid potential misdiagnosis and inappropriate therapy.

Primary gastric angiosarcoma presenting as an asymptomatic gastric submucosal tumor.

Primary gastric angiosarcoma is a rare gastric tumor. Previously reported cases are limited and usually symptomatic. Preoperative diagnosis is difficult and should be differentiated from adenocarcinoma or gastrointestinal stromal tumor. We report a 55-year-old man with primary gastric angiosarcoma presenting as an asymptomatic gastric submucosal tumor. Abdominal ultrasonography showed a heteroechogenic tumor with several notably anechoic portions between the stomach and the gallbladder. Computed tomography showed that the tumor originated from the stomach, and upper gastrointestinal endoscopy showed a large gastric submucosal tumor at the lower body. Laparotomy was performed and a purple circumscribed tumor measuring 8.5 x 5.0 x 4.0 cm was found on the serosal aspect of the lower body. The tumor was soft and spongy with areas of hemorrhagic pools on section. Microscopically, the tumor was composed of proliferative neoplastic spindle to epithelioid cells. The neoplastic cells infiltrated and dissected the smooth muscle as vessel-forming architectures. On immunohistochemical study, the tumor cells were positive for CD34. These findings confirmed a diagnosis of primary gastric angiosarcoma. The patient has been well during the 11-month postoperative follow-up.

De novo urothelial carcinoma in a pediatric recipient of living donor kidney graft.

De novo urothelial carcinoma is relatively rare among post-transplant malignancies and never reported in pediatric kidney transplant recipients. In this paper, we reported one 12-yr-old male case with painless gross hematuria as the initial manifestation of de novo urothelial carcinoma in living donor graft pelvis. We emphasize the importance that cystoscopy and retrograde pyelography of native and transplant kidneys should be performed in all kidney transplant recipients with painless gross hematuria.