Gastric hepatoid adenocarcinoma and familial investigation

Trompetas, Vasilis; Varsamidakis, Nicholas; Frangia, Konstantina; Polimeropoulos, Vasilis; Kalokairinos, Emmanuel

doi:10.1097/00042737-200311000-00015

Cited by 17 publications

(13 citation statements)

References 13 publications

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“…To date, no consensus has been reached regarding the treatment of HAS, as little data are available in the literature (10,11). Usually, the disease is treated using similar strategies as those used to treat gastric adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Hepatoid adenocarcinoma of the stomach: A case report of a rare type of gastric cancer

Shen

Liu

et al. 2015

Oncology Letters

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Abstract. Hepatoid adenocarcinoma of the stomach (HAS) is a rare type of gastric cancer with an extremely poor prognosis. The current study reports a rare case of HAS, characterized by gastric cancer and infiltration of cancer cells into the left liver lobe, as well as lymphadenectasis. The expression of α-fetoprotein (AFP) was markedly increased in the tumor cells of the liver neoplasms. A gastric biopsy indicated highly, moderately and poorly differentiated papillary adenocarcinoma. The patient underwent two cycles of chemotherapy with oxaliplatin (130 mg; day 1) and capecitabine (2 mg, twice daily; days 1-14). At 7 weeks after the chemotherapy, an expanded gastrectomy and radical resection of left lung lobe were performed on the operable lesion. AFP expression was significantly decreased following the procedure. A literature review was also conducted by searching PubMed/Medline, indicating that surgery and chemotherapy may positively affect the outcomes of HAS patients.

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Section: Discussionmentioning

confidence: 99%

Hepatoid adenocarcinoma of the stomach: A case report of a rare type of gastric cancer

Shen

Liu

et al. 2015

Oncology Letters

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“…[7][8][9][10] A large number of gastric adenocarcinomas show Hep Par 1 reactivity. 11 Rare examples of cholangiocarcinomas, yolk sac tumor, and adenocarcinomas of the ovary, adrenal cortex, lung, endocervix, colon, and pancreas have shown focal Hep Par 1 staining. 9,12,13 Hep Par 1 reactivity is also seen in benign small intestinal mucosa and intestinal metaplasia of the esophagus and stomach.…”

mentioning

confidence: 99%

The antigen for Hep Par 1 antibody is the urea cycle enzyme carbamoyl phosphate synthetase 1

Butler

Dong

Cardona

et al. 2008

Laboratory Investigation

116

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Hepatocyte paraffin 1 (Hep Par 1), a murine monoclonal antibody, is widely used in surgical pathology practice to determine the hepatocellular origin of neoplasms. However, identity of the antigen for Hep Par 1 is unknown. The aim of this study was to characterize the Hep Par 1 antigen. To identify the antigen, immunoprecipitation was used to isolate the protein from human liver tissue, and a distinct protein band was detected at approximately 165 kDa. The protein band was also present in small intestinal tissue, but was not present in several other non-liver tissues nor in three human hepatocellular carcinoma cell lines, Huh-7, HepG2, and LH86. The protein was purified and analyzed by mass spectrometry. It was identified as carbamoyl phosphate synthetase 1 (CPS1). CPS1 is a rate-limiting enzyme in urea cycle and is located in mitochondria. We demonstrated that hepatoid tumors (gastric and yolk sac) were immunoreactive with both Hep Par 1 antibody and anti-CPS1 antibody, further confirming the results of mass spectrometric analysis. We found that the three human hepatocellular carcinoma cell lines do not express either CPS1 RNA or protein. We confirmed that the gene was present in these cell lines, suggesting that suppression of CPS1 expression occurs at the transcriptional level. This finding may have relevance to liver carcinogenesis, since poorly differentiated hepatocellular carcinomas exhibit poor to absent immunoreactivity to Hep Par 1. In conclusion, we have identified the antigen for Hep Par 1 antibody as a urea cycle enzyme CPS1. Our results should encourage further investigation of potential role that CPS1 expression plays in liver pathobiology and carcinogenesis. The histological distinction between hepatocellular carcinomas (HCC) and metastatic adenocarcinoma to the liver can sometimes be a challenging dilemma for surgical pathologists, particularly given the histological variants of HCC that can occur. In addition, tumors in other sites can display hepatoid morphologic features, adding to the diagnostic challenge when considering their metastasis to the liver. In the end, a wide panel of immunohistochemical markers is often used for the differential diagnosis of HCC, cholangiocarcinoma and metastatic adenocarcinoma. These markers include alpha-fetoprotein (AFP), polyclonal carcinoembryonic antigen (pCEA), and alpha-1-antitrypsin.

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“…Choriocarcinomatous and hepatoid differentiation of the stomach is very rare. 3 Hepatoid adenocarcinoma frequently shows extensive lymphovascular invasion and early hepatic metastasis. 1 It grows rapidly and metastasizes early to various organs.…”

Section: Introductionmentioning

confidence: 99%

“…2 Hepatoid differentiation of the stomach is also very rare and accounts for approximately 0.38% of all gastric cancers. 3 Hepatoid adenocarcinoma frequently shows extensive lymphovascular invasion and early hepatic metastasis. Its prognosis is also very poor.…”

Section: Introductionmentioning

confidence: 99%

Gastric adenocarcinoma with choriocarcinomatous and hepatoid differentiation

Hwang¹,

Lee²,

Park³

et al. 2011

Basic and Applied Pathology

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We report a patient with gastric adenocarcinoma with choriocarcinomatous and hepatoid differentiation. A 67-year-old man visited our hospital for further evaluations due to gastric adenocarcinoma. The gastric cancer was located in the prepyloric area and appeared to be a protruding mass with an infiltrative growth pattern. Initial pancreatic and postoperative hepatic and pulmonary metastases were detected radiologically. Microscopically, choriocarcinomatous and hepatoid differentiation was observed with a moderately differentiated adenocarcinoma. The choriocarcinomatous components were positive for b-hCG and the hepatoid components were positive for a-fetoprotein (AFP). These uncommon pathological patterns are supposed to arise from the retrodifferentiation pathway of primary gastric adenocarcinoma. The preoperative laboratory data revealed elevated serum AFP (773.4 ng/mL) and carcinoembryonic antigen (62.2 ng/mL), whereas other tests were unremarkable. The prognosis of gastric adenocarcinoma with choriocarcinomatous and hepatoid differentiation is very poor; our patient died 4 months after the operation.

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Gastric hepatoid adenocarcinoma and familial investigation

Cited by 17 publications

References 13 publications

Hepatoid adenocarcinoma of the stomach: A case report of a rare type of gastric cancer

Hepatoid adenocarcinoma of the stomach: A case report of a rare type of gastric cancer

The antigen for Hep Par 1 antibody is the urea cycle enzyme carbamoyl phosphate synthetase 1

Gastric adenocarcinoma with choriocarcinomatous and hepatoid differentiation

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