Hepatoid adenocarcinoma: A wolf in hepatocellular carcinoma's clothing

Nguyen, Paul M.; Hui, Samuel; Robertson, Marcus

doi:10.1002/jgh3.12813

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Our patient had neither a history of cirrhosis nor evidence of recurrent disease in the residual liver. Histology plays a key role in differential diagnosis: for example, in the literature, it is reported that bile pigment has been described in hepatoid carcinoma of the stomach and renal pelvis [ 18 ]. At the same time, Hep Par 1, a highly specific marker of HCC (found positive in our patient), can help in the differential diagnosis between HAC and HCC, but unfortunately, some HAC tumors may still show positive staining.…”

Section: Discussionmentioning

confidence: 99%

“…It follows that in addition to having to validate its usefulness, its universality of applicability will have to be defined regardless of the primary tumor [ 2 ]. In their case series, Nguyen et al concluded instead that HAC is an extremely rare neoplasm that remains a differential diagnosis in AFP-producing liver lesions without the imaging features typical of HCC [ 2 , 18 ]. Additionally, because of this assumption, our case differed in the absence of underlying cirrhotic lesions at the time of relapse.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Hepatocellular Carcinoma Recurrence in Ovarian Site after 12 Years Mimicking a Hepatoid Adenocarcinoma: Case Report

Restaino¹,

Pellecchia

Poli

et al. 2023

JCM

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Hepatoid carcinoma of the ovary (HCO) is a tumor that resembles, both histologically and cytologically, hepatocarcinoma (HCC) in a patient with a non-cirrhotic liver not involved by the disease. Hepatoid carcinoma is an extremely rare histologic subtype of ovarian cancer and should be distinguished from metastatic HCC. Here, we report the rare case of a 67-year-old woman with ovarian recurrence of HCC 12 years after first diagnosis. The patient was being followed by oncologists because she had been diagnosed with HCV-related HCC (Edmonson and Stainer grade 2, pT2 N0 M0, G2, V1) in 2009. She had undergone surgery for enlarged left hepatectomy to the 4th hepatic segment with cholecystectomy and subsequent placement of a Kehr drain. The preoperative alpha-fetoprotein (AFP) level was 8600 ng/mL, while the postoperative value was only 2.7 ng/mL. At the first diagnosis, no other localizations of the disease, including the genital tract, were found. At the time of recurrence, however, the patient was completely asymptomatic: her liver function was within normal limits with negative blood indices, except for an increased blood dosage of AFP (467 ng/mL), and CA125, which became borderline (37.4 IU/mL). The oncologist placed an indication for a thoracic abdominal CT scan, which showed that the residual liver was free of disease, and the presence of a formation with a solid–cystic appearance and some calcifications at the left adnexal site. The radiological findings were confirmed on level II gynecological ultrasound. The patient then underwent a radical surgery of hysterectomy, bilateral oophorectomy, pelvic peritonectomy, and omentectomy by a laparotomic approach, with the sending of intraoperative extemporaneous histological examination on the annexus site of the tumor mass, obtaining RT = 0. Currently, the patient continues her gyneco-oncology follow-up simultaneously clinically, in laboratory, and instrumentally every 4 months. Our study currently represents the longest elapsed time interval between first diagnosis and disease recurrence, as evidenced by current data in the literature. This was a rather unique and difficult clinical case because of the rarity of the disease, the lack of scientific evidence, and the difficulty in differentiating the primary hepatoid phenotype of the ovary from an ovarian metastasis of HCC. Several multidisciplinary meetings for proper interpretation of clinical and anamnestic data, with the aid of immunohistochemistry (IHC) on histological slides were essential for case management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Hepatocellular Carcinoma Recurrence in Ovarian Site after 12 Years Mimicking a Hepatoid Adenocarcinoma: Case Report

Restaino¹,

Pellecchia

Poli

et al. 2023

JCM

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“…Fourth, the number of enrolled GHA patients was relatively small. GHA is an extremely rare malignancy, with published literature limited to case series and observational studies ( 9 , 23 ). The incidence is difficult to estimate because of the rarity of the disease; one East Asian population study reported an incidence of 0.014 per 100,000 people ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Differential diagnostic value of tumor markers and contrast-enhanced computed tomography in gastric hepatoid adenocarcinoma and gastric adenocarcinoma

Dong

Wang

et al. 2023

Front. Oncol.

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ObjectiveThis study aimed to investigate the effectiveness of tumor markers and contrast-enhanced computed tomography (CE-CT) in differentiating gastric hepatoid adenocarcinoma (GHA) from gastric adenocarcinoma (GA).MethodsThis retrospective study included 160 patients (44 with GHA vs. 116 with GA) who underwent preoperative CE-CT. Preoperative serum concentrations of tumor biomarkers and CT imaging features were analyzed, including alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), tumor location, growth pattern, size, enhancement pattern, cystic changes, and mass contrast enhancement. Multivariate logistic regression analyses were performed to evaluate useful tumor markers and CT imaging features for differentiating GHA from GA.ResultsWhen compared to GA, GHA showed a higher serum AFP [13.27 ng/ml (5.2–340.1) vs. 2.7 ng/ml (2.2–3.98), P <0.001] and CEA levels [4.07 ng/ml (2.73–12.53) vs. 2.42 ng/ml (1.38–4.31), P <0.001]. CT imaging showed GHA with a higher frequency of tumor location in the gastric antrum (P <0.001). GHA had significantly lower attenuation values at the portal venous phase [PCA, (82.34 HU ± 8.46 vs. 91.02 HU ± 10.62, P <0.001)] and delayed phase [DCA, (72.89 HU ± 8.83 vs. 78.27 HU ± 9.51, P <0.001)] when compared with GA. Multivariate logistic regression analyses revealed that tumor location, PCA, and serum AFP level were independent predictors of differentiation between GHA and GA. The combination of these three predictors performed well in discriminating GHA from GA, with an AUC of 0.903, a sensitivity of 86.36%, and a specificity of 81.90%.ConclusionsIntegrated evaluation of tumor markers and CT features, including tumor location, PCA, and serum AFP, allowed for more accurate differentiation of GHA from GA.

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Primary Peritoneal Hepatoid Adenocarcinoma Patients Treated by Complete Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Buiron

Grange

Rousset

et al. 2023

Indian J Surg Oncol

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Hepatoid adenocarcinoma: A wolf in hepatocellular carcinoma's clothing

Cited by 4 publications

References 6 publications

A Rare Case of Hepatocellular Carcinoma Recurrence in Ovarian Site after 12 Years Mimicking a Hepatoid Adenocarcinoma: Case Report

A Rare Case of Hepatocellular Carcinoma Recurrence in Ovarian Site after 12 Years Mimicking a Hepatoid Adenocarcinoma: Case Report

Differential diagnostic value of tumor markers and contrast-enhanced computed tomography in gastric hepatoid adenocarcinoma and gastric adenocarcinoma

Primary Peritoneal Hepatoid Adenocarcinoma Patients Treated by Complete Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

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