Hepatocellular carcinoma metastatic to skin: diagnostic utility of antihuman hepatocyte antibody in combination with albumin <i>in situ</i> hybridization

Wood, A. J.; Lappinga, Paul J.; Ahmed, Iftikhar

doi:10.1111/j.1600-0560.2008.01029.x

Cited by 14 publications

(16 citation statements)

References 10 publications

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“…A 12-yearold child with HCC and cutaneous metastases on the trunk has been reported. 2,[139][140][141] This antigen of the hepatocyte mitochondria has been considered as the most specific and sensitive marker of normal and neoplastic hepatocytes. The epidermis is commonly spared, except in some cases that exhibited ulceration or, less commonly, pagetoid spread.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Cutaneous Metastases From Internal Malignancies

Alcaraz

Cerroni

Rütten

et al. 2012

The American Journal of Dermatopathology

225

104

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Skin metastases occur in 0.6%-10.4% of all patients with cancer and represent 2% of all skin tumors. Skin metastases from visceral malignancies are important for dermatologists and dermatopathologists because of their variable clinical appearance and presentation, frequent delay and failure in their diagnosis, relative proportion of different internal malignancies metastasizing to the skin, and impact on morbidity, prognosis, and treatment. Another factor to take into account is that cutaneous metastasis may be the first sign of clinically silent visceral cancer. The relative frequencies of metastatic skin disease tend to correlate with the frequency of the different types of primary cancer in each sex. Thus, women with skin metastases have the following distribution in decreasing order of frequency of primary malignancies: breast, ovary, oral cavity, lung, and large intestine. In men, the distribution is as follows: lung, large intestine, oral cavity, kidney, breast, esophagus, pancreas, stomach, and liver. A wide morphologic spectrum of clinical appearances has been described in cutaneous metastases. This variable clinical morphology included nodules, papules, plaques, tumors, and ulcers. From a histopathologic point of view, there are 4 main morphologic patterns of cutaneous metastases involving the dermis, namely, nodular, infiltrative, diffuse, and intravascular. Generally, cutaneous metastases herald a poor prognosis. The average survival time of patients with skin metastases is a few months. In this article, we review the clinicopathologic and immunohistochemical characteristics of cutaneous metastases from internal malignancies, classify the most common cutaneous metastases, and identify studies that may assist in diagnosing the origin of a cutaneous metastasis.

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Section: Hepatocellular Carcinomamentioning

confidence: 99%

Cutaneous Metastases From Internal Malignancies

Alcaraz

Cerroni

Rütten

et al. 2012

The American Journal of Dermatopathology

225

104

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“…Reports suggest that cutaneous metastasis occurs in 0.8%‐2.7% of HCC cases . Cases tend to occur after an established diagnosis of primary HCC, with skin metastases as the initial manifestation in only 1%‐5% …”

Section: Discussionmentioning

confidence: 99%

“…Metastasis to the skin may occur by hematogenous or lymphatic spread, or direct contiguous tissue invasion. Iatrogenic implantation of HCC metastasis along a needle tract is a recognized complication of percutaneous ethanol injection, liver biopsy, and transcatheter arterial chemoembolization . Cutaneous metastasis has also been reported as the first sign of recurrence following liver resection and liver transplantation for HCC; the majority of these cases have presented within or adjacent to the surgical scar.…”

Section: Discussionmentioning

confidence: 99%

“…Histopathological diagnosis of cutaneous metastases of HCC may be challenging, particularly poorly‐differentiated lesions, which may be mistaken for metastatic melanoma. Features that intimate a diagnosis of HCC metastasis include polygonal tumor cells arranged in trabeculae, the presence of bile, positive immunohistochemical staining for hepatocyte antigen and AFP, and albumin detected by in situ hybridization …”

Section: Discussionmentioning

confidence: 99%

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Cutaneous metastasis as the first presentation of hepatocellular carcinoma

et al. 2018

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“…Extrahepatic metastasis of HCC occurs in about 30-50% of patients, and it depends on HCC stages [1][2][3][4]. Extrahepatic metastases to various unusual sites from HCC have been reported in several case reports [5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

Terada

2011

J. Maxillofac. Oral Surg.

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A 55-year-old man consulted to our hospital complaining of a gingival tumor. Oral examination showed granulation tissue-like polypoid tumors (2 × 2 × 1 cm) in the left upper gingiva. A clinical diagnosis of granulation tissue was made, and an incisional biopsy was performed. It showed carcinoma cells in the submucosa. They were arranged in compact and sinusoidal patterns. A few bile plugs and one Mallory-like body were recognized by meticulous examination. An immunohistochemical study showed that the tumor cells were positive for hepatocyte paraffin-1 (HepPar-1), cytokeratins (AE1/3 and CAM6.2), and p53 protein. The carcinoma cells were negative for vimentin, prostate specific antigen, CD10, and α-fetoprotein. The Ki-67 labeling was 49%. A histological diagnosis of hepatocellular carcinoma (HCC) metastatic to the gingiva was made. Then, the patient was referred to hepatology unit. A blood laboratory test showed elevated elevated liver enzymes, and positive antibody to hepatitis C virus. Liver cirrhosis was also present. Imaging modalities including US, CT, and MRI revealed multiple hepatic tumors. Metastases to other sides were not recognized. The patient was diagnosed as cirrhosis and HCC with an extrahepatic metastasis to the gingiva. The patient was now treated by chemotherapy. The present case shows that HCC can manifest as small gingival tumors, and meticulous HE examination and immunoreactive HepPar-1 are useful in the diagnosis of HCC in extrahepatic metastatic sites.

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Hepatocellular carcinoma metastatic to skin: diagnostic utility of antihuman hepatocyte antibody in combination with albumin in situ hybridization

Abstract: The combination of antihuman hepatocyte antibody and albumin ISH is highly sensitive and specific for HCC metastatic to skin and is useful in the differential diagnosis of a poorly differentiated cytokeratin-positive neoplasm.

Cited by 14 publications

References 10 publications

Cutaneous Metastases From Internal Malignancies

Cutaneous Metastases From Internal Malignancies

Cutaneous metastasis as the first presentation of hepatocellular carcinoma

Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

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