The designation'hepatoid carcinoma' has been introduced as a unique type of carcinoma that arises outside the liver but resembles, to a considerable extent, hepatocellular carcinoma both histologically and immunohistochemically in its staining for alpha-fetoprotein (AFP). The minimum histological criteria of hepatoid carcinomas are the evidence of AFP production and abundant eosinophilic cytoplasm. These tumors have been reported in the ovary, the lung, the stomach, the renal pelvis, and the bladder. We, in this study, present a rare patient with primary hepatoid carcinoma of the ovary (OHC) and review the previous reports.

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A 4-year-old girl with hypomelanosis of Ito (HI) was referred to the cardiologist for an absence of pulses in the lower extremities. Medical history included hydrocephalus treated with ventriculoperitoneal shunt and congenital glaucoma. She always remained asymptomatic. Physical examination showed upper-body hypertrophy and a repeatedly measured systolic pressure difference between the upper and lower extremities of 35 mm Hg. Contrastenhanced multidetector computed tomography ( Figure 1) showed aortic hypoplasia immediately distal to the origin of renal arteries. Three-dimensional reconstruction obtained from contrast-enhanced multidetector computed tomography (Figure 2) revealed an abrupt diameter reduction in the aorta below the renal arteries. The aorta was divided into very small vessels to supply the lower extremities, mimicking a "pseudo-cauda equina." Despite these findings, patient has remained asymptomatic during follow-up, without hypertension and with good exercise tolerance.HI is a multisystemic neurocutaneous disease associated with genetic disorders such as mosaicism or transloca- Multiple small vessels arise to irrigate the lower extremities (white arrows), mimicking a pseudo-cauda equina. The asterisk points out the ventriculoperitoneal shunt.

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FIGURE 2. A, Persistent foramen ovale with a vent (arrow) covered by the membrane. B, The persistent embryonic right venous valve seen through right atriotomy (arrow). C, Competent tricuspid valve (arrow) and its relation with the membrane. D, After resection of the membrane (arrow), the sinus venosus is shown.