Metastatic hepatoid carcinoma of ovarian origin - a case report from northern Pakistan

Abstract

HighlightsHepatoid carcinoma of the ovary is rapidly progressing rare epithelial ovarian tumor.The term ‘hepatoid’ refers to the morphological resemblance with hepatocellular carcinoma.Final diagnosis is made via positive staining for alpha fetoprotein along with immunohistochemistryCombination chemotherapy can be considered superior over the targeted agents while treating this tumor.

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

“…Hepatoid carcinoma of the ovary presents at a median age of 57 years (range, 35-78 years), with most patients showing elevated levels of circulating AFP (20 of 22; 90.9%) and/or CA125 (14 of 22; 63.6%). [1][2][3][4][5][6][7][8][9][10][12][13][14][15][16][17][18][19][20][21] Increased serum carcinoembryonic (CEA) and inhibin levels have been demonstrated in 3 and 1 individual cases, respectively. 3,7,10,12 The overwhelming majority of affected women present with disseminated disease involving the pelvis, peritoneum, and invading adjacent organs (Table).…”

“…Only 5 patients in this review series presented with disease confined to the ovary (5 of 25; 20%). 2,[7][8][9]11 Metastases are rare at initial diagnosis (4 of 28; 10.7%), 4,17,19,21 and so is lymph node involvement (1 of 28; 3.6%). 16 The median follow-up of this group was 11.5 months (range, 1-60 months).…”

“…16 The median follow-up of this group was 11.5 months (range, 1-60 months). Of 26 patients with available information on outcome, 11 died of disease (42.3%), 1,4-6,9,16,17,20 5 were alive with disease at last follow-up (19.2%), 3,11,12,15,21 and 10 had no evidence of disease after treatment (38.5%). † Of the 5 cases with disease confined to the ovary, 2 had no evidence of disease at last follow-up, 2,8 1 was alive with abdominopelvic recurrence, 11 1 died of metastatic disease 6 months after the initial diagnosis, 9 and 1 did not have any information on outcome.…”

“…In 8 of these 11 cases, the authors describe the presence of disseminated/bulky abdominopelvic 1,2,4,5,16 or retroperitoneal 6 disease at the time of death. The 5 patients who were alive with disease at last follow-up showed abdominopelvic disease, 11 synchronous abdominopelvic disease and distant metastases, 21 synchronous lymph node and bone metastases, 12 bone metastases, 15 and biochemical relapse, 3 respectively. The small group of women who developed new or showed progression of known lymph node metastases during follow-up (3 of 26; 11.5%) showed a very aggressive course.…”

“…16,17 In this scenario, as well as in cases where AFP is not performed, the use of additional hepatocellular antigens, such as hepatocyte-paraffin 1 and glypican 3, is usually informative (Figure 1, F). 17,19,21 The periodic acid-Schiff-positive, diastaseresistant hyaline globules may stain for AFP. 18 CA125 and CEA are positive in 30% (3 of 10) 1,5,9,10,13,14 and 64.3% (9 of 14) 1,5,[7][8][9][10][11]14 of HCOs, respectively, with the latter sometimes showing a canalicular pattern.…”