Hepatoid carcinomas (HCs) are a group of heterogeneous tumors that are similar to hepatocellular carcinoma (HCC). Pancreatic hepatoid carcinoma (PHC) is a very rare disease. The present study presents the case of a 63-year-old male patient with PHC with synchronous liver, spleen and stomach metastasis, in an aim to enhance our understanding of this disease. A 63-year-old male presented with abdominal distension for 3 months and slightly developed asthenia and anorexia. Laboratory tests of serum tumor markers revealed the alpha fetoprotein level was markedly elevated (>10,00.0 ng/ml). The radiological findings of computed tomography, magnetic resonance imaging, diffusion-weighted imaging and magnetic resonance cholangiopancreatography revealed a malignant tumor in the tail of the pancreas with synchronous liver, spleen, stomach and retroperitoneal lymph node metastasis. A post-operative immunohistochemical analysis revealed that the tumor cells in the tail of the pancreas exhibited positivity for glypican-3; right liver positivity was also observed for CK-18 and weak positivity for glypican-3, suggestive of primary PHC. On the whole, PHC is very rare, and exhibits morphological features similar to those of HCC. Its diagnosis is mainly achieved via morphological analysis and immunohistochemical staining of the tissue specimens, since the clinical manifestation and laboratory test results are often unspecific.
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