Combined choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma in the oesophagus

Abstract

We describe an oesophageal tumour composed of choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma. The choriocarcinomatous areas and hepatoid adenocarcinomatous areas contained beta human chorionic gonadotropin-positive cells and alpha fetoprotein-positive cells, respectively. The small cell carcinomatous areas contained cells positive for serotonin or adrenocorticotrophic hormone, while the tubular adenocarcinomatous areas contained cells positive for carcinoembryonic antigen. Non-neoplastic gastric type columnar epithelium was found directly adjoing the tumour at the oral side. This tumour, with its unprecedented histology combination of tissues may have originated in Barrett's oesophagus, although we could not confirm a history of chronic gastro-oesophageal reflux.

Structures of the normal esophagus and Barrett?s esophagus

“…Adenocarcinoma [48], squamous cell carcinoma [49], choriocarcinoma [50], mucoepidermoid carcinoma [51], adenosquamous carcinoma [52], yolk sac tumor [53], carcinoid tumor [54], hepatoid carcinoma with small cell carcinoma [55], adenocarcinoma with lymphoid stroma [56], adenocarcinosarcoma [57,58], neuroendocrine carcinoma [59,60], and small cell carcinoma [61] have all been reported to arise in Barrett's esophagus. Those who encounter tumors other than adenocarcinoma arising in Barrett's mucosa should report them.…”

α-Fetoprotein–Producing Liver Carcinomas of Primary Extrahepatic Origin

“…Apart from certain germ cell neoplasms, there have been increasing reports of AFP-producing carcinomas in extrahepatic sites, like the lung, 8,11 gastrointestinal tract, 9,10,15,17,[19][20][21][22]24 female genital tract 26,29 and urinary tract. 2,34 Some of these tumors have hepatoid morphology, prompting one to search for a hepatocellular carcinoma (HCC) within the liver and ascertain the serum AFP levels and tumor immunoreactivity for AFP.…”

Hepatoid Esophageal Carcinoma: a Rare Cause of Elevated Alfa Fetoprotein

“…Most have been reported as arising in the stomach [1,2]. To our knowledge, only seven have been documented in the esophagus [3][4][5][6][7][8][9]. All index cases were males with a wide range of age distribution (44-80 years).…”