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1
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Mi S, Jin Z, Huang J. Primary pancreatic hepatoid carcinoma: A case report. Asian J Surg 2024:S1015-9584(24)01907-9. [PMID: 39237407 DOI: 10.1016/j.asjsur.2024.08.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024] Open
Affiliation(s)
- Shizheng Mi
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoxing Jin
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiwei Huang
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
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2
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Iwasaki S, Hidaka H, Uojima H, Kubo H, Adachi K, Wada N, Kubota K, Nakazawa T, Shibuya A, Kusano C. A case of successful treatment with lenvatinib in primary hepatoid adenocarcinoma of the gallbladder that was difficult to distinguish from hepatocellular carcinoma. Clin J Gastroenterol 2022; 15:1108-1114. [DOI: 10.1007/s12328-022-01686-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022]
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3
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Chhabra P, Sancheti S, Sali AP, Somal PK, Sharma A, Brar RS, Gulia A, Kapoor R. Approach to the Diagnosis of Hepatoid Adenocarcinoma, an Under-reported Entity: Case Series and Review of Literature. ASIAN JOURNAL OF ONCOLOGY 2022. [DOI: 10.1055/s-0042-1748629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractHepatoid adenocarcinoma is a rare type of extra-hepatic adenocarcinoma which exhibits morphological, functional, and immunohistochemical features of hepatocellular carcinoma, hence correct diagnosis poses a challenge. The most frequent site of this tumor is stomach and rarely occurs in ovaries, lung, gallbladder, pancreas, uterus, and other sites. We present four cases of hepatoid adenocarcinoma of our hospital at rare sites like lungs and gallbladder along with literature review and a simplified approach to diagnosis. In absence of adequate immunohistochemistry or radiological findings often this entity is missed or misdiagnosed as metastatic hepatocellular carcinoma. We have analyzed these hepatoid adenocarcinoma cases in terms of various clinical, serological, histo-morphological, and immunohistochemical parameters, and propose a systematic approach to correctly diagnose this entity.
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Affiliation(s)
- Prerna Chhabra
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Akash Pramod Sali
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Puneet Kaur Somal
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Aishwarya Sharma
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Rahat Singh Brar
- Department of Radio-diagnosis, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Ashish Gulia
- Department of Orthopaedic Oncology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
| | - Rakesh Kapoor
- Department of Radiation-oncology, Homi Bhabha Cancer Hospital and Research Centre, Punjab, (A Unit of Tata Memorial Centre), India
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4
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Okura K, Esaki M, Nara S, Ban D, Takamoto T, Shimada K, Hiraoka N. Hepatoid carcinoma and related entities of the extrahepatic bile duct: A clinicopathological study of four cases. Pathol Int 2022; 72:332-342. [PMID: 35472251 DOI: 10.1111/pin.13226] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/02/2022] [Indexed: 01/01/2023]
Abstract
Hepatoid carcinoma or related entities (HPC/RTs) are extremely rare, especially in the extrahepatic bile duct (EHBD). Only a few case reports have been published. We analyzed the clinicopathological features of HPCs/RTs in EHBD. HPC/RT of extrahepatic cholangiocarcinoma (eCCA) cases were selected based on the histological characteristics and immunohistochemical detection of spalt-like transcription factor 4 (SALL4) and/or alpha-fetoprotein (AFP). Four HPC/RT cases arose in the distal but not in the perihilar EHBD. The four patients with HPC/RT included one female and three males with a median age of 77 years. There are various macroscopic types of HPC/RT. The predominant histological features were two solid-type carcinomas that mimicked hepatocellular carcinoma and two well-differentiated tubular adenocarcinomas. Immunohistochemically, SALL4 and glypican-3 were expressed in all cases, and AFP was expressed in one case. Cancer cell phenotypes included intestinal, pancreatobiliary, and mixed pancreatobiliary and intestinal types. Focal neuroendocrine differentiation and severe perineural and lymphovascular invasions were also observed. HPC/RT recurred in two patients within 2 years, and one patient died 13 months postoperatively. It is suggested that the HPC/RT of EHBD shares common characteristics with HPC/RT arising in various organs, and has some unique characteristics. HPC/RT of EHBD might be more aggressive than conventional eCCA.
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Affiliation(s)
- Keisuke Okura
- Department of Analytical Pathology, National Cancer Center Research Institute, Tokyo, Japan
| | - Minoru Esaki
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Nara
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Ban
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Takamoto
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuaki Shimada
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuyoshi Hiraoka
- Department of Analytical Pathology, National Cancer Center Research Institute, Tokyo, Japan
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5
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Zeng SX, Tan SW, Fong CJTH, Liang Q, Zhao BL, Liu K, Guo JX, Tao J. Hepatoid carcinoma of the pancreas: A case report and review of the literature. World J Clin Cases 2020; 8:1116-1128. [PMID: 32258082 PMCID: PMC7103969 DOI: 10.12998/wjcc.v8.i6.1116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/16/2020] [Accepted: 02/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatoid carcinoma (HC) is an extremely rare neoplasm that is morphologically similar to hepatocellular carcinoma. HC has been described in various organs; however, HC of the pancreas is extremely rare. To our knowledge, only 38 cases have been reported. We present a case of HC of the pancreas in a 36-year-old male patient.
CASE SUMMARY A 36-year-old cachexic man with no significant past medical history was transferred to our hospital with a history of painless jaundice, elevated blood glucose and significant weight loss. Lab tests showed elevated serum transaminases, bilirubin and alpha-fetoprotein levels. Magnetic resonance imaging of the upper abdomen showed a diffusely enlarged pancreas, appearing “sausage-shaped”. Magnetic resonance cholangiopancreatography showed upstream ductal dilation secondary to stricture of the main pancreatic duct and the common bile duct, which were not visible. Immunohistochemistry of biopsied tissue from a percutaneous pancreatic biopsy showed tumor cell positivity for HepPar1, polyclonal carcinoembryonic antigen and CK19, suggestive of HC of the pancreas. The characteristics of 39 patients with HC of the pancreas were reviewed.
CONCLUSION HC of the pancreas is more prevalent in males, and patients have a median age of 57 years. It is most commonly asymptomatic or presents as abdominal back pain, and the pancreatic tail is the most common location. At the time of diagnosis, liver metastasis is often present.
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Affiliation(s)
- Shao-Xiong Zeng
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Si-Wei Tan
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Christ-Jonathan Tsia Hin Fong
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Qiong Liang
- Department of Pathology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Bin-Liang Zhao
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Ke Liu
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Jia-Xiang Guo
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Jin Tao
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
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6
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Qian X, Zhou D, Gao B, Wang W. An alpha-fetoprotein-negative hepatoid adenocarcinoma of the gallbladder with squamous differentiation. Hepatobiliary Surg Nutr 2020; 9:116-118. [PMID: 32140496 DOI: 10.21037/hbsn.2019.12.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Xiaohui Qian
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
| | - Dongkai Zhou
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
| | - Bingqiang Gao
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
| | - Weilin Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.,Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou 310009, China.,Research Center of Diagnosis and Treatment Technology for Hepatocellular Carcinoma of Zhejiang Province, Hangzhou 310009, China.,Clinical Medicine Innovation Center of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou 310009, China.,Clinical Research Center of Hepatobiliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310009, China
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7
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Akturk G, Sagol O, Unek T, Ozbilgin M, Egeli T, Karademir S, Obuz F, Astarcioglu IK. Alpha-Fetoprotein-Secreting Gallbladder Carcinoma: a Case Report. J Gastrointest Cancer 2019; 49:528-531. [PMID: 28462448 DOI: 10.1007/s12029-017-9950-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Guray Akturk
- Department of Pathology, Cigli Education and Research Hospital, Izmir, Turkey.
| | - Ozgul Sagol
- Department of Pathology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tarkan Unek
- Department of General Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Mucahit Ozbilgin
- Department of General Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tufan Egeli
- Department of General Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sedat Karademir
- Department of General Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Funda Obuz
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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8
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Yoshioka S, Ishida M, Okano K, Sandoh K, Ebisu Y, Miyasaka C, Yamamoto T, Ryota H, Satoi S, Tsuta K. Cytological features of hepatoid adenocarcinoma of the gallbladder: A case report with immunocytochemical analyzes. Diagn Cytopathol 2018; 46:711-715. [PMID: 29637715 DOI: 10.1002/dc.23935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 12/15/2022]
Abstract
Hepatoid adenocarcinoma is defined as an extrahepatic malignant neoplasm showing morphological and immunohistochemical resemblance of hepatocellular carcinoma. The occurrence of this type of tumor in the gallbladder is extremely rare. In this study, we report the first cytological case of hepatoid adenocarcinoma of the gallbladder. An 80-year-old Japanese female was found to have a tumorous lesion in the gallbladder. Papanicolaou smear of the ascites demonstrated a few epithelial cell clusters composed of round to oval neoplastic cells with distinct cell border and large centrally-located nuclei. Tumor touch smear of the resected tumor revealed the presence of two distinct neoplastic components. The first component was composed of clusters or sheets of epithelial cells with distinct cell border, relatively rich clear cytoplasm, and centrally-located nuclei, as seen in the ascites specimen. The other component was composed of tall columnar cells with large basally-oriented nuclei, and glandular formation was noted as well. Immunocytochemical analyzes of the touch smear material demonstrated that the former component was positive for HepPar1, thus it was considered as a hepatoid adenocarcinoma, and the latter component deemed as a typical adenocarcinoma. Histopathological and immunohistochemical examination of the resected gallbladder tumor confirmed a diagnosis of hepatoid adenocarcinoma. The characteristic cytological features of hepatoid adenocarcinoma are the presence of sheets or clusters of neoplastic cells with distinct cell border and centrally-located nuclei. Immunocytochemical analysis for HepPar1 may help its diagnosis. Demonstration of hepatoid adenocarcinoma is important in the cytological specimen because this type of tumor shows an aggressive clinical course.
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Affiliation(s)
- Saya Yoshioka
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Mitsuaki Ishida
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Kimiaki Okano
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Kaori Sandoh
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Yusuke Ebisu
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Chika Miyasaka
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | | | - Hironori Ryota
- Department of Surgery, Kansai Medical University, Osaka, Japan
| | - Sohei Satoi
- Department of Surgery, Kansai Medical University, Osaka, Japan
| | - Koji Tsuta
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
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9
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Akimoto Y, Kato H, Matsumoto K, Harada R, Oda S, Fushimi S, Mizukawa S, Yabe S, Uchida D, Seki H, Tomoda T, Yamamoto N, Horiguchi S, Tsutsumi K, Yagi T, Okada H. Pancreatic Hepatoid Carcinoma Mimicking a Solid Pseudopapillary Neoplasm: A Challenging Case on Endoscopic Ultrasound-guided Fine-needle Aspiration. Intern Med 2016; 55:2405-11. [PMID: 27580541 DOI: 10.2169/internalmedicine.55.6741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A 59-year-old man was admitted to our hospital for treatment of a 45 mm pancreatic mass found during a medical examination. Endoscopic ultrasound-guided fine-needle aspiration cytology showed polygonal cells with pseudopapillary structures. The tumor cells were positive for nuclear/cytoplasmic β-catenin and CD10, and negative for chromogranin A. After a tentative diagnosis of a solid pseudopapillary neoplasm, middle pancreatectomy was performed. Histologically, polygonal cells with abundant eosinophilic cytoplasm formed in the trabeculae and were immunohistochemically positive for HepPar1 and protein induced by vitamin K absence or antagonist-II. The tumor was finally diagnosed to be pancreatic hepatoid carcinoma. No recurrence occurred for 12 months, even without adjuvant chemotherapy.
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Affiliation(s)
- Yutaka Akimoto
- Department of Gastroenterology & Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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10
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Karayiannakis AJ, Kakolyris S, Giatromanolaki A, Courcoutsakis N, Bolanaki H, Chelis L, Sivridis E, Simopoulos C. Hepatoid Adenocarcinoma of the Gallbladder : Case Report and Literature Review. J Gastrointest Cancer 2016; 43 Suppl 1:S139-44. [PMID: 21935757 DOI: 10.1007/s12029-011-9326-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Anastasios J Karayiannakis
- Second Department of Surgery, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece.
| | - Stylianos Kakolyris
- Department of Clinical Oncology, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
| | - Alexandra Giatromanolaki
- Department of Pathology, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
| | - Nikos Courcoutsakis
- Department of Radiology and Medical Imaging, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
| | - Helen Bolanaki
- Second Department of Surgery, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
| | - Leonidas Chelis
- Department of Clinical Oncology, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
| | - Efthimios Sivridis
- Department of Pathology, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
| | - Constantinos Simopoulos
- Second Department of Surgery, Democritus University of Thrace, Medical School, 68 100, Alexandroupolis, Greece
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11
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Chen YY, Huang WH, Yang HR. A Gallbladder Polyp in a Patient with Chronic Hepatitis B. Gastroenterology 2015; 149:e3-4. [PMID: 26518182 DOI: 10.1053/j.gastro.2015.03.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 02/10/2015] [Accepted: 03/18/2015] [Indexed: 12/02/2022]
Affiliation(s)
- Yang-Yuan Chen
- Division of Gastroenterology, General Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Hsin Huang
- Division of Gastroenterology, General Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Horng-Ren Yang
- Division of Gastroenterology, General Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
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12
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Devi NRS, Sathyalakshmi R, Devi J, Lilly SM. Hepatoid Adenocarcinoma of the Gall Bladder-A Rare Variant. J Clin Diagn Res 2015; 9:ED09-10. [PMID: 26435955 DOI: 10.7860/jcdr/2015/10799.6324] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 05/26/2015] [Indexed: 11/24/2022]
Abstract
Hepatoid adenocarcinoma is a rare variant of extra hepatic adenocarcinoma, consisting of foci of both adenomatous and hepatocellular differentiation with morphological and functional resemblance to hepatocellular carcinoma and hence correct diagnosis is a challenge. The most frequent site is stomach. We present this case of hepatoid carcinoma of the gallbladder for its rarity and difficulty in diagnosis which on histology showed papillae, sheets and trabaculae of polygonal cells with eosinophilic cytoplasm and vesicular nuclei with prominent nucleoli with adjacent foci showing high grade dysplasia.
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Affiliation(s)
- Nalli R Sumitra Devi
- Professor, Department of Pathology, Stanley Medical College , Tamil Nadu Dr. MGR Medical University, India
| | - R Sathyalakshmi
- Assistant Professor, Department of Pathology, Stanley Medical College , Tamil Nadu Dr. MGR Medical University, India
| | - J Devi
- Postgraduate, Department of Pathology, Stanley Medical College , Tamil Nadu Dr. MGR Medical University, India
| | - S Mary Lilly
- HOD & Professor, Department of Pathology, Stanley Medical College , Tamil Nadu Dr. MGR Medical University, India
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13
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Wang XY, Bao WQ, Hua FC, Zuo CT, Guan YH, Zhao J. AFP-producing hepatoid adenocarcinoma of appendix: a case report of 18F-FDG PET/CT. Clin Imaging 2014; 38:526-528. [PMID: 24721022 DOI: 10.1016/j.clinimag.2014.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 01/02/2014] [Accepted: 02/27/2014] [Indexed: 02/07/2023]
Abstract
Hepatoid adenocarcinoma (HAC) is a rare tumor. We described here a rare case of appendix HAC. A 59-year-old man underwent F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for gradually elevated alpha-Fetoprotein level. Multiple masses in the abdominal cavity with moderate FDG uptake were revealed, suggesting malignant tumor with peritoneal metastasis. The patient underwent radical resection, and the postoperative pathological result was HAC originated from the appendix. To our knowledge, it is the first report of HAC of the appendix. Our study suggests that FDG PET/CT may help in detecting the primary tumor and the metastases of HAC.
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Affiliation(s)
- Xin-Yan Wang
- Division of PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200235, People's Republic of China; Department of Radiology, First Teaching Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, People's Republic of China
| | - Wei-Qi Bao
- Division of PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200235, People's Republic of China
| | - Feng-Chun Hua
- Division of PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200235, People's Republic of China.
| | - Chuan-Tao Zuo
- Division of PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200235, People's Republic of China
| | - Yi-Hui Guan
- Division of PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200235, People's Republic of China
| | - Jun Zhao
- Division of PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai 200235, People's Republic of China
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14
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Steen S, Wolin E, Geller SA, Colquhoun S. Primary hepatocellular carcinoma ("hepatoid" carcinoma) of the pancreas: a case report and review of the literature. Clin Case Rep 2013; 1:66-71. [PMID: 25356215 PMCID: PMC4184752 DOI: 10.1002/ccr3.26] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 09/19/2013] [Accepted: 10/10/2013] [Indexed: 12/13/2022] Open
Abstract
Key Clinical Message We present a case of hepatocellular carcinoma located within the pancreas. These tumors occur in the body and tail of the pancreas, with a male predominance, and at a younger age. Tumors with pure hepatocellular histopathology have better survival and recurrence rates and should be offered surgical therapy if possible.
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Affiliation(s)
- Shawn Steen
- Department of Surgical Oncology, John Wayne Cancer Institute Santa Monica, California
| | - Edward Wolin
- Department of Medical Oncology, Cedars Sinai Medical Center Beverly Hills, California
| | - Stephen A Geller
- Department of Pathology, Cedars Sinai Medical Center Beverly Hills, California
| | - Steven Colquhoun
- Department of Surgery, Cedars Sinai Medical Center Beverly Hills, California
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15
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Wang Y, Liu YY, Han GP. Hepatoid adenocarcinoma of the extrahepatic duct. World J Gastroenterol 2013; 19:3524-3527. [PMID: 23801851 PMCID: PMC3683697 DOI: 10.3748/wjg.v19.i22.3524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/03/2013] [Accepted: 05/22/2013] [Indexed: 02/06/2023] Open
Abstract
Hepatoid carcinoma is a unique type of extrahepatic tumor associated with hepatic differentiation and displays the morphological and functional features of hepatocellular carcinoma. Hepatoid carcinoma of the extrahepatic duct has rarely been reported in the literature. We report a 62-year-old man who presented with epigastric discomfort, xanthochromia, dull pain of the right shoulder, nausea and pruitus. Microscopic examination of the extrahepatic duct indicated that the tumor was primarily composed of “hepatoid cells”, which were characterized by an eosinophilic cytoplasm, enlarged nucleus and prominent nucleoli. The cells were arranged in nests or proliferated in a trabecular pattern. Immunohistochemistry indicated that the tumor cells were positive for hepatocyte paraffin 1 and cytokeratins 8 and 18. Based on these findings, this case was diagnosed as hepatoid carcinoma of the extrahepatic duct.
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16
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Chen YY, Hsu WH, Hu HM, Wu DC, Lin WY. A case of alpha-fetoprotein-producing esophageal adenocarcinoma. Kaohsiung J Med Sci 2013; 29:106-10. [PMID: 23347813 DOI: 10.1016/j.kjms.2012.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 02/10/2012] [Indexed: 11/29/2022] Open
Abstract
Alpha-fetoprotein is a well-known tumor marker in the screening and follow-up of hepatocellular carcinoma. In Taiwanese society, a high prevalence of hepatitis and hepatoma and elevation of alpha-fetoprotein associated with liver function impairment usually suggested clinics undertake further examination for liver or genital tumor. We report the case of 45-year-old man who was found to have an alpha-fetoprotein-producing esophageal adenocarcinoma with an initial presentation of liver function impairment and rapid elevation of alpha-fetoprotein. Esophageal cancer was diagnosed via endoscope and a biopsy proved the presence of adenocarcinoma. A small endoscopic biopsy specimen failed to identify the alpha-fetoprotein positive tumor cell. Esophagectomy was performed and histopathological study of surgical specimen revealed grade II adenocarcinoma with regional metastatic lymphadenopathy. Immunohistochemical study was focal positive for alpha-fetoprotein. Serum alpha-fetoprotein declined transiently after esophagectomy and fluctuation of alpha-fetoprotein level was noted during the treatment with adjuvant chemotherapy. Finally, 19 months after the operation, the patient died due to multiple organ metastases with multiple organ failure. Thus, a small specimen for upper endoscopy may not be sufficient in the presence of alpha-fetoprotein-producing adenocarcinoma. Monitoring of serum alpha-fetoprotein may be useful in the evaluation and follow-up of esophageal alpha-fetoprotein-producing adenocarcinoma.
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Affiliation(s)
- Yi-Yu Chen
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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17
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Zener R, Gologan O, Sands N, Zeitouni AG. Hepatoid adenocarcinoma of the anterior skull base: a case report. SKULL BASE REPORTS 2011; 1:95-8. [PMID: 23984209 PMCID: PMC3743597 DOI: 10.1055/s-0031-1276723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 12/21/2010] [Indexed: 12/03/2022]
Abstract
We report the first case of hepatoid adenocarcinoma of the skull base, as well as the first reported case in the head and neck region. Hepatoid adenocarcinoma is a rare, aggressive, extrahepatic malignancy with a distinct morphological similarity to hepatocellular carcinoma, in the absence of primary hepatic disease. A 45-year-old man presented with sinus headaches and retro-orbital pain and was found to have a nasopharyngeal mass on endoscopy and a large, destructive sinonasal mass extending intracranially on imaging. Histo- and cytopathological features were similar to hepatocellular carcinoma, and the cells were immunoreactive for α-fetoprotein, epithelial membrane antigen, periodic acid-Schiff, cytokeratin (CK)8/18, CK19, and S100.
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Affiliation(s)
- Rebecca Zener
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
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18
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Ellouze S, Slim C, Ahmad G, Naourez G, Ali A, Héla M, Mariem K, Mohamed BA, Tahia B. Hepatoid adenocarcinoma of the gallbladder. World J Surg Oncol 2011; 9:103. [PMID: 21914163 PMCID: PMC3180410 DOI: 10.1186/1477-7819-9-103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 09/13/2011] [Indexed: 11/20/2022] Open
Abstract
Hepatoid adenocarcinoma is a rare variant of extrahepatic adenocarcinoma which behaves like hepatocellular carcinoma in morphology and functionality. We present a rare case of hepatoid adenocarcinoma of the gallbladder which invades deeply the liver bed, in a 59-year-old woman. Histologically, most of the mass in the gallbladder was composed of cells with eosinophilic cytoplasm arranged in a trabecular pattern, which resembled hepatocellular carcinoma. The main differential diagnosis was hepatocellular carcinoma with invasion into the gallbladder. The gallbladder origin of the hepatoid adenocarcinoma was verified by the presence of foci of conventional adenocarcinoma, the recognition of high-grade dysplasia in the adjacent epithelium and the absence of cirrhosis.
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Affiliation(s)
- Sameh Ellouze
- Department of Pathology, Habib Bourguiba Hospital, road El Ain., 3029, Sfax, Tunisia.
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19
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Lee JH, Lee KG, Paik SS, Park HK, Lee KS. Hepatoid adenocarcinoma of the gallbladder with production of alpha-fetoprotein. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2011; 80:440-4. [PMID: 22066073 PMCID: PMC3204683 DOI: 10.4174/jkss.2011.80.6.440] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/08/2010] [Indexed: 11/30/2022]
Abstract
Hepatoid adenocarcinoma (HAC) is a tumor with aberrant hepatocellular differentiation that occurs in extrahepatic organs. HAC of the gallbladder is rare, and cases of alpha-fetoprotein production are extremely rare. A 61-year-old man was diagnosed with gallbladder adenocarcinoma after laparoscopic cholecystectomy. A radical operation including resection of liver bed and lymph node dissection was performed, and no tumor cell was found. However, at postoperative 19 months, he showed lymphadenopathy of the portocaval area and tumor thrombi in the right portal vein with high levels of serum alpha-fetoprotein. After right hemihepatectomy and portahepatis lymph node dissection was performed, he was diagnosed with metastatic HAC. On reviewing the gallbladder specimen, the tumor finally demonstrated HAC as the primary origin. Despite adjuvant therapy, the patient died from multiple liver metastasis 26 months after cholecystectomy. Although HAC of the gallbladder is a very rare malignancy, awareness of its existence is critical to avoid misdiagnosis.
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Affiliation(s)
- Jae Hoon Lee
- Department of Surgery, Hanyang University College of Medicine, Seoul, Korea
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20
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Kanzaki R, Yamada T, Gotoh K, Takahashi H, Murata M, Tomita Y, Yano M, Ohigashi H, Sasaki Y, Ishikawa O. Surgical resection for hepatocellular carcinoma with metastasis to the gallbladder: report of a case. Surg Today 2011; 41:285-91. [PMID: 21264771 DOI: 10.1007/s00595-010-4223-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 01/12/2010] [Indexed: 12/27/2022]
Abstract
A metastatic tumor of the gallbladder is rare. There have so far been no detailed reports of a resection of the metastasis of hepatocellular carcinoma (HCC) to the gallbladder published in the English literature. This report presents the case of a surgical resection for hepatocellular carcinoma with metastasis to the gallbladder. A 48-year-old woman consulted her primary care physician due to chest discomfort. Tumors in the liver and gallbladder were unexpectedly found and she was thus referred to this hospital. The radiologic studies showed two tumors. A round-shaped tumor, 30 mm in diameter, in the fossa of the gallbladder of the liver protruded into the lumen of the gallbladder, and a lobulated shaped tumor, measuring 13 mm, was in S5 of the liver. Angiography demonstrated that these tumors showed a pattern of early enhancement and washout. An en bloc resection of the gallbladder and the liver surrounding the gallbladder was performed, and the final diagnosis was moderately differentiated HCC in segment S5 with gallbladder metastasis. The patient is currently doing well 2 years after surgery, without any signs of recurrence. This case demonstrated that good clinical outcome could be achieved by performing surgery in HCC patients with metastasis to the gallbladder.
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Affiliation(s)
- Ryu Kanzaki
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, Japan
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21
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Letters to the Editor. Am Surg 2009. [DOI: 10.1177/000313480907500610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Sakamoto K, Monobe Y, Kouno M, Moriya T, Sasano H. Hepatoid adenocarcinoma of the gallbladder: Case report and review of the literature. Pathol Int 2008; 54:52-6. [PMID: 14674996 DOI: 10.1111/j.1440-1827.2004.01578.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A rare case of hepatoid adenocarcinoma (HAC) of the gallbladder occurred in a 72-year-old man who presented with abdominal pain and was admitted to hospital. Ultrasonography and computed tomography revealed a mass in the gallbladder, multiple nodules in the liver and enlargement of the lymph nodes. He was diagnosed as having a gallbladder carcinoma with multiple liver and lymph node metastases. Cholecystectomy and partial hepatectomy was performed. Histologically, most of the mass in the gallbladder was composed of cells with eosinophilic cyto-plasm arranged in a trabecular pattern, which resembled hepatocellular carcinoma, but there was a component of well-differentiated adenocarcinoma in the mucosa. Immunohistochemically these hepatoid tumor cells were positive for Hepatocyte (Hepatocyte Paraffin 1: Hep Par1), which is considered highly sensitive and highly specific for hepatocyte differentiation. Based on these findings, this case was diagnosed as hepatoid adenocarcinoma of the gallbladder, which is generally a vary rare neoplasm in the literature, but should be included in the differential diagnosis of a mass in the gallbladder.
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23
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van den Bos IC, Hussain SM, Dwarkasing RS, Stoop H, Zondervan PE, Krestin GP, de Man RA. Hepatoid adenocarcinoma of the gallbladder: a mimicker of hepatocellular carcinoma. Br J Radiol 2008; 80:e317-20. [PMID: 18065642 DOI: 10.1259/bjr/97773297] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
We present a case of a large gallbladder tumour in a patient with no known liver disease and elevated alpha-fetoprotein (AFP), in whom a differential diagnosis from hepatocellular carcinoma (HCC) in a non-cirrhotic liver was particularly difficult given the combination of the size of the tumour, solitary nature, elevated AFP and striking resemblance with HCC at histology. In presenting this patient, we would like to emphasise the role of MRI as a problem-solving tool for analysis of rare tumours of non-hepatocellular origin, including hepatoid adenocarcinoma of the gallbladder.
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Affiliation(s)
- I C van den Bos
- Department of Radiology, University Medical Center Rotterdam, The Netherlands.
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24
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Gakiopoulou H, Givalos N, Liapis G, Agrogiannis G, Patsouris E, Delladetsima I. Hepatoid adenocarcinoma of the gallbladder. Dig Dis Sci 2007; 52:3358-62. [PMID: 17510803 DOI: 10.1007/s10620-007-9807-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Accepted: 02/13/2007] [Indexed: 02/08/2023]
Affiliation(s)
- H Gakiopoulou
- A' Department of Pathology, Medical School, The National & Kapodistrian University of Athens, Athens, Greece.
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25
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Orditura M, Lieto E, Ferraraccio F, De Cataldis G, Troiani T, Castellano P, Catalano G, Ciardiello F, Galizia G, De Vita F. Hepatoid carcinoma colliding with a liposarcoma of the left colon serosa presenting as an abdominal mass. World J Surg Oncol 2007; 5:42. [PMID: 17448253 PMCID: PMC1866233 DOI: 10.1186/1477-7819-5-42] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Accepted: 04/22/2007] [Indexed: 11/10/2022] Open
Abstract
Background Hepatoid adenocarcinoma (HAC) is a peculiar type of extrahepatic adenocarcinoma generally characterized by adenocarcinomatous and hepatocellular carcinoma (HCC)-like foci. Stomach is the most frequent site where hepatoid adenocarcinoma occurs, although it has been described in many other organs. On the other side, liposarcoma is a rare, malignant tumor that develops from fat cells. Case presentation We describe here a case of hepatoid carcinoma in collision with a liposarcoma of the left colon serosa in a 71-year-old man. It presented as an abdominal mass involving several organs, falsely mimicking metastatic colonic adenocarcinoma. Recognition of this entity was evident on microscopic evaluation following surgery. The patient had an objective response following liposomal antracycline chemotherapy, with a 3-year overall survival. Conclusion To our knowledge, this is the first case of a hepatoid tumor colliding with a liposarcoma of the left colon serosa reported to date.
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Affiliation(s)
- Michele Orditura
- Cattedra di Oncologia Medica, Seconda Università degli Studi di Napoli °Ospedale "Da Procida", Salerno, Naples, Italy
- Department of Clinical and Experimental Medicine, Second University of Naples School of Medicine, Naples, Italy c/o II Policlinico Via S. Pansini, 5 80131, Naples, Italy
| | - Eva Lieto
- Cattedra di Chirurgia Generale ed Epatobiliare, Seconda Università degli Studi di Napoli Ospedale "Da Procida", Salerno, Naples, Italy
| | - Francesca Ferraraccio
- Cattedra di Anatomia e Istologia Patologica – Seconda Università degli Studi di Napoli °Ospedale "Da Procida", Salerno, Naples, Italy
| | - Giuseppe De Cataldis
- Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi – A. Lanzara" Naples, Italy
| | - Teresa Troiani
- Cattedra di Oncologia Medica, Seconda Università degli Studi di Napoli °Ospedale "Da Procida", Salerno, Naples, Italy
| | - Paolo Castellano
- Cattedra di Chirurgia Generale ed Epatobiliare, Seconda Università degli Studi di Napoli Ospedale "Da Procida", Salerno, Naples, Italy
| | - Giuseppe Catalano
- Cattedra di Oncologia Medica, Seconda Università degli Studi di Napoli °Ospedale "Da Procida", Salerno, Naples, Italy
| | - Fortunato Ciardiello
- Cattedra di Oncologia Medica, Seconda Università degli Studi di Napoli °Ospedale "Da Procida", Salerno, Naples, Italy
| | - Gennaro Galizia
- Cattedra di Chirurgia Generale ed Epatobiliare, Seconda Università degli Studi di Napoli Ospedale "Da Procida", Salerno, Naples, Italy
| | - Ferdinando De Vita
- Cattedra di Oncologia Medica, Seconda Università degli Studi di Napoli °Ospedale "Da Procida", Salerno, Naples, Italy
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Hameed O, Xu H, Saddeghi S, Maluf H. Hepatoid carcinoma of the pancreas: a case report and literature review of a heterogeneous group of tumors. Am J Surg Pathol 2007; 31:146-52. [PMID: 17197931 DOI: 10.1097/01.pas.0000213370.79300.e1] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Hepatoid carcinomas are tumors that display, at least focally, cytologic and/or architectural features of hepatocellular carcinoma. They have been described in several organs, most notably in the stomach and ovary. We report a case of hepatoid carcinoma of the pancreas that developed in a 41-year-old woman in association with a pancreatic endocrine carcinoma. The fine needle aspiration material was characterized by the presence of monotonous, small-to-medium sized tumor cells with round nuclei and finely granular chromatin, intermixed with more atypical tumor cells displaying larger nuclei with coarse clumped chromatin, prominent nucleoli, and moderate amounts of foamy cytoplasm. The excised specimen displayed a poorly differentiated pancreatic endocrine carcinoma associated with well-defined islands of larger tumor cells growing in a perisinusoidal pattern which, based on their immunohistochemical profile and the demonstration of bile, proved to represent a hepatoid component. This case and prior examples in the literature suggest that hepatoid carcinomas of the pancreas appear to be a heterogeneous group of tumors (pure or associated with another histologic component) that are often associated with early liver metastasis and a short survival, although those arising as a component of endocrine tumors seem to fare slightly better. Hepatoid carcinoma of the pancreas should be included in the differential diagnosis of pancreatic tumors composed of large eosinophilic cells.
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Affiliation(s)
- Omar Hameed
- Lauren V. Ackerman Laboratory of Surgical Pathology and the Department of Pathology, Washington University School of Medicine, St Louis, MO, USA.
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Sakamoto K, Kimura N, Tokumura H, Ogasawara T, Moriya T, Sasano H. Hepatoid adenocarcinoma of the gallbladder. Histopathology 2005; 47:649-51. [PMID: 16324210 DOI: 10.1111/j.1365-2559.2005.02187.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
A 54-year-old man presented to his doctor with hematemesis and was found at endoscopy to have an ulcerated lesion in his stomach. A computed tomography scan was performed and revealed a mass in the fundus of the stomach. Multiple other lesions were identified in the liver, lungs, retroperitoneal space, and mesentery. Gross examination showed two separate gastric lesions containing nests and single cells with mucin intermixed with sheets of tumor cells with abundant eosinophilic cytoplasm invading throughout the wall of the stomach. Immunohistochemical studies were performed and the cells were positive for hepatocyte, MOC 31, cytokeratin A1/A3, and CK 7, and were negative for CK 20, alpha-fetoprotein, and thyroid transcription factor. The histologic features together with the immunohistochemical findings were diagnostic of a hepatoid adenocarcinoma of the stomach. Hepatoid adenocarcinoma is a rare tumor associated with a very poor prognosis. Immunohistochemical studies may help to identify the characteristic features of hepatoid differentiation and prevent mistaking this tumor for other types of carcinoma.
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Affiliation(s)
- Jose Antonio Plaza
- Department of Pathology and Radiology, The Ohio State University Medical Center, 410 West 10th Avenue, Columbus, OH 43210, USA
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Franke A, Ströbel P, Fackeldey V, Schäfer R, Göller T, Becker HP, Schöneich R, Müller-Hermelink HK, Marx A. Hepatoid Thymic Carcinoma. Am J Surg Pathol 2004; 28:250-6. [PMID: 15043316 DOI: 10.1097/00000478-200402000-00014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We describe the clinicopathologic findings in a so far unrecognized thymic tumor. The tumor occurred in a 70-year-old woman with respiratory distress but neither myasthenia gravis nor other symptoms. Metastases or another primary tumor were absent. The well-circumscribed neoplasm was located in the thymic region, measured 18 x 12 x 8 cm, and showed a homogeneous, tan-colored, soft cut surface. By histology, the tumor lacked a true capsule and a lobular growth pattern, was almost devoid of stroma, and infiltrated among remnant thymus lobules. The polygonal tumor cells formed solid sheets, trabeculae, or occurred as single cells that resembled hepatocytes. Proliferative activity was low. Portal structures, sinuses, and bile were absent as were areas of conventional thymoma, adenocarcinoma, or germ cell tumor. The tumor expressed cytokeratins 7 and 19, alpha1-antitrypsin, alpha1-antichymotrypsin, and hep-Par-1. Alpha-fetoprotein (AFP), human beta-chorionic gonadotropin (beta-HCG), placental alkaline phosphatase, CD5, CD30, CD31, CD34, CD45, CD68, CD99, S-100, HMB45, desmin, actin, or neuroendocrine markers were not expressed, and intratumorous CD1a+ or TdT+ immature T cells were absent. AFP was repeatedly undetectable in the blood. Mediastinal tumor recurrence was detected 6 months after surgery. Following radiochemotherapy, the patient has remained free of disease for 26 months. We conclude that this tumor is a thymic carcinoma (WHO type C thymoma). A diagnosis of hepatoid yolk sack tumor appears unlikely considering absence of a bona fide germ cell component, lack of AFP expression, and the patient's female gender. Because of its morphologic and immunohistochemical features, we propose the term "hepatoid thymic carcinoma" for this new type of thymic carcinoma.
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Affiliation(s)
- A Franke
- Department of Visceral and Thoracic Surgery, Central Army Hospital, Koblenz, Germany
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30
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Mizejewski GJ. Biological role of alpha-fetoprotein in cancer: prospects for anticancer therapy. Expert Rev Anticancer Ther 2002; 2:709-35. [PMID: 12503217 DOI: 10.1586/14737140.2.6.709] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
alpha-fetoprotein has long been considered the 'gold-standard' in the field of tumor markers. During the several decades since the recognition of mammalian alpha-fetoprotein as a tumor-associated fetal protein, it has been purified, characterized, cloned and sequenced for use in the clinical diagnostic laboratory. However, the biological role of alpha-fetoprotein in the regulation of cancer growth has received comparatively little attention. Only during the last decade has the modulatory role of alpha-fetoprotein in neoplastic growth been realized and implemented in experimental models. This review examines the basis for the current consensus that alpha-fetoprotein does indeed regulate neoplastic growth through the presence of an alpha-fetoprotein cell surface receptor that undergoes internalization to the cell interior. Studies involving uptake of this fetal protein have since culminated in radio imaging reports as well as the use of alpha-fetoprotein as an anticancer drug conjugate. Finally, the therapeutic utilization of alpha-fetoprotein and its peptidic fragments as growth-response modifiers encompasses biological events, such as apoptosis G-coupled signal transduction, gene therapy, vaccination and cancer chemoprevention.
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Affiliation(s)
- Gerald J Mizejewski
- Division of Molecular Medicine, Wadsworth Center for Laboratory and Research, NYS Health Dept., Empire State Plaza, Albany, NY 02201, USA
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