Hepatoid Carcinoma of the Ovary: Clinical, Histopathologic, and Immunophenotypic Features

Acosta, Andrés; Pins, Michael

doi:10.5858/arpa.2017-0485-rs

Cited by 14 publications

(17 citation statements)

References 30 publications

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“…Differentiation diagnosis of hepatoid yolk sac tumor is required to clinically distinguish ovarian cancer from hepatocellular carcinoma, which is defined by the expression of broad-spectrum cytokeratins, AFP, and hepatocellular antigens with the absence of sex cord and germ cell markers. Pins et al summarized 27 cases of ovarian liver cancer reported on PubMed in 2019 [ 27 ]. These patients had a median age of 57 years (range: 35–78 years).…”

Section: Discussionmentioning

confidence: 99%

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Ding

Liu

et al. 2022

J Ovarian Res

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Background Complex epithelial neoplasms of the ovary (CENO), an uncommon pathological histotype in ovarian cancer, comprises adenosquamous carcinoma and adenocarcinoma with metaplasia. Owing to the rarity of relevant reports, there are currently no statistics on outcomes based on large samples. Meanwhile high-grade serous ovarian cancer (HGSOC) is the most common histotype in ovarian cancer which has a recognized first-line treatment regimen and poor prognosis. Thus, we aimed to determine the characteristics, prognosis, and independent predictors of survival for CENO, compare them with those of HGSOC and construct prognostic predictive models and nomograms. Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to determine patients diagnosed with CENO or HGSOC from 2000 to 2017. Clinical, demographic, and treatment characteristics were compared between these groups. Propensity score matching, Cox risk regression analysis, Kaplan–Meier survival curves, and the Least Absolute Shrinkage and Selection Operator regression analysis were employed for analyzing the data. Results Here, 31,567 patients with HGSOC and 216 patients with CENO between 2000 and 2017 in the SEER database were enrolled. Age < 57 years, unmarried, and early-stage diseases were more common in patients with CENO than in those with HGSOC. Women with CENO were less likely to receive adjuvant chemotherapy (65.7% vs. 79.4%) but more likely to receive radiotherapy (6.0% vs. 0.8%; both p < 0.001) than those with HGSOC. Year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors for overall and cancer-specific survival in CENO. Overall survival rates were significantly lower for CENO than for more malignant HGSOC. Conclusions In summary, CENO was rare in ovarian cancer, while the year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors. Compared with other common malignant ovarian tumors, CENO had a poor prognosis. Prognostic predictive models and nomograms had been determined to predict the individual survival rates of patients with CENO. These methods could improve evaluations of survival and therapeutic decisions for patients.

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Section: Discussionmentioning

confidence: 99%

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Ding

Liu

et al. 2022

J Ovarian Res

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“…APA is a rare kind of malignant tumor, which could originate from various organs, such as the lung, ovary, kidney, esophagus, stomach, small intestine, colorectal, and appendix (3,10,(14)(15)(16)(17)(18). The present study focused on the clinicopathological features of APA-GI via a retrospective analysis.…”

Section: Discussionmentioning

confidence: 99%

The Clinicopathological Characteristics of Alpha-Fetoprotein-Producing Adenocarcinoma of the Gastrointestinal Tract—A Single-Center Retrospective Study

Kong

Tian

et al. 2021

Front. Oncol.

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Alpha-fetoprotein (AFP)-producing adenocarcinoma from the gastrointestinal tract (APA-GI) is a rare type of highly malignant tumor with a poor prognosis. It may originate from any site along the GI tract with similar clinicopathological characteristics. As limited research had ever described the characteristics of APA-GI, the present article intends to systemically investigate the clinicopathological characteristics of APA-GI from a single center's retrospective study to deepen the understanding of the disease. A total of 177 patients pathologically diagnosed with APA-GI between 2010 and 2017 at the Second Affiliated Hospital of Zhejiang University, School of Medicine, were included. Also, clinical data of 419 gastric cancers and 609 colorectal cancers from The Cancer Genome Atlas database were also extracted. Clinical information of patients from Second Affiliated Hospital of Zhejiang University, School of Medicine, was collected, and a median follow-up of 14.5 months was performed to investigate clinical characteristics of APA-GI. For the pathological characteristics of APA-GI, hematoxylin–eosin sections were reviewed, and immunohistochemistry of AFP was performed. The results showed that the primary tumor could develop through the whole GI tract, including the esophagus (0.6%), stomach (83.1%), duodenum (1.1%), ileum (0.6%), appendix (0.6%), colon (5.1%), and rectum (7.9%). Hepatoid adenocarcinoma is the main pathological feature of APA-GI. AFP expression level in tumor tissue was not strictly associated with serum AFP or hepatoid differentiation. The prognosis of APA-GI was worse than that of common adenocarcinoma of the GI tract and liver metastasis, and high AFP levels suggest poor prognosis in patients with APA-GI. Therefore, the present study was the first research to systemically explore the clinicopathological characteristics of APA-GI. APA-GI occurs through the whole GI tract with a significantly worse prognosis than common adenocarcinoma of GI. APA-GI should be regarded as one kind of disease for its similar clinicopathological characteristics within patients.

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“…There is abundant evidence to support this opinion. The onset age of HCO is similar to that of epithelial ovarian cancer (22). In some cases, the tumor tissue was mixed with serous or mucinous carcinoma, also suggesting epithelial origin on the ovarian surface (23).…”

Section: Discussionmentioning

confidence: 92%

“…In our case, immunohistochemical studies revealed SALL4 positivity. SALL4 is an important marker of germ-cell tumors( 19), but it is not expressed in hepatocellular tumors, and there have also been reports of other hepatoid adenocarcinomas expressing SALL4 (20)(21)(22). Therefore, SALL4 may be a potential indicator to differentiate HCO from metastatic HCC.…”

Section: Discussionmentioning

confidence: 99%

SALL4 as an indicator for the diagnosis of Hepatoid Carcinoma of the Ovary: A case report and literature review

2023

Preprint

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Primary hepatoid carcinoma of the ovary (HCO) is a rare, aggressive ovarian malignant tumor, morphologically resembling hepatocellular carcinoma and featuring with elevated serum alpha-fetoprotein (AFP) and Carbohydrate Antigen 125 (CA125). We report a case of a 64-year-old postmenopausal Chinese woman who presented with lower abdominal pain and vaginal bleeding. The patient went through a maximal debulking surgery and the pathological biopsy revealed hepatoid carcinoma of the ovary. The immunohistochemical staining showed tumor cells were positive for AFP, spalt-like transcription factor 4 (SALL4), monoclonal anti-cytokeratin (AE1/3) and tumor protein 53 (P53). After operation and one course of chemotherapy, the serum AFP dramatically declined to normal level and maintained for almost 2 years. Literature review demonstrates that the pathological and immunohistochemical features of HCO are variable, while elevated serum AFP is a common characteristic and SALL4 can be adopted to differentiate HCO from Hepatocellular carcinoma (HCC). Although there is no conventional treatment for HCO, complete tumor debulking surgery followed by chemotherapy as shown in this case can be a potential option. The serum AFP, CA125 rather than human epididymis protein 4 (HE4) can be employed as possible biomarkers to track treatment and monitor recurrence.

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Hepatoid Carcinoma of the Ovary: Clinical, Histopathologic, and Immunophenotypic Features

Cited by 14 publications

References 30 publications

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

The Clinicopathological Characteristics of Alpha-Fetoprotein-Producing Adenocarcinoma of the Gastrointestinal Tract—A Single-Center Retrospective Study

SALL4 as an indicator for the diagnosis of Hepatoid Carcinoma of the Ovary: A case report and literature review

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