Hepatoid microcarcinoma of the pancreas: A case report and review of the literature

Huang, Shih‐Chiang; Chang, Hui S.; Yeh, Ta‐Sen; Ng, Kwai‐Fong; Chen, Tse–Ching

doi:10.4103/2319-4170.106142

Cited by 14 publications

(3 citation statements)

References 12 publications

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“…Ampullary LCNECs in the literature are limited to 24 case reports before ours, as identified by our review to date ( Table 2 ) [ 11 , 18 , 24 , 26 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. Only 14 cases were pure LCNECs [ 24 , 26 , 56 , 57 , 59 , 60 , 61 , 62 , 63 , 66 ], while the other 11 had other components [ 11 , 18 , 26 , 59 , 60 , 65 , 66 , 68 ]. Many of these patients had early recurrence with metastases, especially in the liver [ 24 , 56 , 58 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 68 ].…”

Section: Discussionmentioning

confidence: 99%

“…Only 14 cases were pure LCNECs [ 24 , 26 , 56 , 57 , 59 , 60 , 61 , 62 , 63 , 66 ], while the other 11 had other components [ 11 , 18 , 26 , 59 , 60 , 65 , 66 , 68 ]. Many of these patients had early recurrence with metastases, especially in the liver [ 24 , 56 , 58 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 68 ].…”

Section: Discussionmentioning

confidence: 99%

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Ampullary Large-Cell Neuroendocrine Carcinoma, a Diagnostic Challenge of a Rare Aggressive Neoplasm: A Case Report and Literature Review

et al. 2022

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Ampullary large-cell neuroendocrine carcinomas (LCNECs) are extremely rare, and available data are limited on case reports. They present with jaundice, non-specific abdominal pain, or weight loss, imitating adenocarcinoma. Their incidence increases due to the improved diagnostic techniques. However, preoperative diagnosis remains challenging. We report the case of a 70-year-old man with a history of metabolic syndrome, cholecystectomy, and right hemicolectomy, presenting with jaundice. Laboratory results showed increased liver biochemistry indicators and elevated CA 19-9. Esophagogastroduodenoscopy revealed an ulcerative tumor on the ampulla of Vater, and the biopsy revealed neuroendocrine carcinoma. Although computed tomography (CT) detected enlarged regional lymph nodes, the positron emission tomography (PET) showed a hyperactive lesion only in this area. Pylorus-preserving pancreatoduodenectomy with R0 resection was performed. Pathologic evaluation of the 3.1 × 1.9 cm tumor revealed an LCNEC with immunohistochemical positivity at Synaptophysin, EMA, CD56, and cytokeratin CK8/18. The Ki-67 index was 45%. Two out of the nine dissected lymph nodes were occupied by the neoplasm. The patient was discharged home free of symptoms, and adjuvant chemotherapy with carboplatin + etoposide was initiated. A comprehensive review of the reported cases showed that the preoperative biopsy result was different from the final diagnosis in few cases, regarding the subtypes. Conventional radiology cannot identify small masses, and other methods, such as endoscopy, magnetic resonance cholangiopancreatography (MRCP), and FDG-PET scan, might aid the diagnosis. Diagnosis is based on histology and immunohistochemical markers of the surgical specimens. The treatment of choice is pancreatoduodenectomy, followed by adjuvant chemotherapy. However, recurrence is frequent, and the prognosis remains poor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ampullary Large-Cell Neuroendocrine Carcinoma, a Diagnostic Challenge of a Rare Aggressive Neoplasm: A Case Report and Literature Review

et al. 2022

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“…Hepatoid carcinoma (HC) is a rare extrahepatic epithelial malignancy exhibiting morphological and immunohistochemical features similar to hepatocellular carcinoma (1). HC most frequently occurs in the ovaries, colon or stomach, with only a few cases of pancreatic adenocarcinoma (PAC) of the hepatoid subtype having been reported (2)(3)(4)(5)(6). However, several metastatic lesions, including the poorly differentiated adenocarcinoma of the pancreas and stomach, have been reported to exhibit hepatoid morphology (2,7).…”

Section: Introductionmentioning

confidence: 99%

A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review

Iliesiu,

Toma,

Ciongariu

et al. 2023

Oncol Lett

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In rare cases, metastatic adenocarcinomas of different origin may exhibit the features of hepatoid carcinoma (HC), a rare malignant epithelial tumor, most commonly occurring in the ovaries and stomach, as well as in the pancreas and biliary ducts. A case of a 72-year-old female patient who developed a highly aggressive, poorly differentiated pancreatic ductal adenocarcinoma with peritoneal carcinomatosis, demonstrating hepatoid differentiation upon conventional hematoxylin and eosin staining is reported in the present study. The patient presented with severe abdominal pain, and the radiological investigations performed revealed ovarian and hepatic tumor masses and peritoneal lesions, which were surgically removed. The gross examination of the peritoneum and omentum revealed multiple solid, firm, grey-white nodules, diffusely infiltrating the adipose tissue. The microscopic examination revealed a malignant epithelial proliferation, composed of polygonal cells with abundant eosinophilic cytoplasm and irregular, pleomorphic nuclei. Certain cells presented with intracytoplasmic mucus inclusions, raising suspicion of a HC with an uncertain histogenesis. Immunohistochemical staining was performed, and the tumor cells were found to be positive for cytokeratin (CK)7, CK18 and mucin 5AC, whereas negative staining for CK20, caudal-type homeobox transcription factor 2, α-fetoprotein, paired box gene 8, GATA-binding protein 3 and Wilms tumor 1 were documented. Thus, the diagnosis of metastatic pancreatic adenocarcinoma was established. The main aim of the present study was to provide further knowledge concerning poorly differentiated metastatic adenocarcinoma resembling HC, emphasizing the histopathological and immunohistochemical features of these malignant lesions and raising awareness of the diagnostic difficulties that may arise, as well as the importance of the use immunohistochemistry in differentiating carcinomas of uncertain histogenesis.

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Primary hepatocellular carcinoma (“hepatoid” carcinoma) of the pancreas: a case report and review of the literature

Steen

Wolin

Geller

et al. 2013

Clinical Case Reports

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Hepatoid microcarcinoma of the pancreas: A case report and review of the literature

Cited by 14 publications

References 12 publications

Ampullary Large-Cell Neuroendocrine Carcinoma, a Diagnostic Challenge of a Rare Aggressive Neoplasm: A Case Report and Literature Review

Ampullary Large-Cell Neuroendocrine Carcinoma, a Diagnostic Challenge of a Rare Aggressive Neoplasm: A Case Report and Literature Review

A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review

Primary hepatocellular carcinoma (“hepatoid” carcinoma) of the pancreas: a case report and review of the literature

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