Well-differentiated gall bladder hepatoid carcinoma producing alpha-fetoprotein: a case report

Abstract

IntroductionGall bladder carcinoma is rare, and metastatic gall bladder carcinoma from hepatocellular carcinoma has been reported in only a few patients.Case presentationWe present a 73-year-old man with a history of hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma. He received transcatheter arterial chemoembolization, and was diagnosed to have an alpha-fetoprotein producing gall bladder tumor with intraluminal growth. Open cholecystectomy was performed. Pathologic examination of the lesion revealed a well-differentiated hepatoid carcinoma. The lesion was thought most likely to be a metastatic lesion from previous hepatocellular carcinoma. His alpha-fetoprotein level dropped to normal levels five months after the surgery.ConclusionThis unusual intraluminal growing tumor proved to be a well-differentiated hepatoid carcinoma, most likely a metastatic lesion from previous hepatocellular carcinoma. This case reminds clinicians that in looking for likely hepatocellular carcinoma recurrence, when no detectable hepatic lesion can account for an elevated alpha-fetoprotein level, the gall bladder should be included in the search for the site of metastasis.

Rare Malignant and Semimalignant Epithelial Neoplasms of the Biliary Tract

“…Few cases of hepatoid carcinoma of the gallbladder have been reported (Nakashima et al 2000;Maitra et al 2001;Sakamoto et al 2004Sakamoto et al , 2005Gakiopoulou et al 2007;Koswara et al 2007;van den Bos et al 2007;Kao et al 2009). The tumors may be associated with elevated serum AFP (van den Bos et al 2007).…”