Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature

Haninger, Diana M.; Kloecker, Goetz; Bousamra, Michael; Nowacki, Michael; Slone, Stephen P.

doi:10.1038/modpathol.2013.170

Cited by 87 publications

(114 citation statements)

References 18 publications

(36 reference statements)

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“…Tumor cells have eosinophilic cytoplasm, centrally located nuclei proliferating in a trabecular pattern, and express AFP, HepPar1, HEA125 and MOC31 (1,2). The lung is the primary site in approximately 5% of cases of HAC (1).…”

Section: Introductionmentioning

confidence: 99%

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Valle

Thomas

Kim

et al. 2017

Molecular and Clinical Oncology

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Abstract. Hepatoid adenocarcinoma (HAC) is a rare tumor that typically originates in gastrointestinal tissue, such as the stomach, but can also occasionally originate in the lung. The majority of HACs express α-fetoprotein (AFP) on tumor cells, and serum AFP can be used as a marker of response to treatment or disease progression. HAC has a poor prognosis, although early diagnosis and aggressive treatment can result in long-term survival. To the best of our knowledge, this is the first reported case of HAC metastasizing to the tonsil. Irradiation using intensity-modulated radiation therapy (IMRT) to 30 Gray (Gy) achieved a significant, and durable tumor response. IMRT can be considered for local control of HAC at other metastatic sites of disease. IntroductionHepatoid adenocarcinoma (HAC) is a rare α-fetoprotein (AFP)-producing tumor that morphologically resembles hepatocellular carcinoma. Tumor cells have eosinophilic cytoplasm, centrally located nuclei proliferating in a trabecular pattern, and express AFP, HepPar1, HEA125 and MOC31 (1,2). The lung is the primary site in approximately 5% of cases of HAC (1). HAC metastasis to the brain, liver, adrenal gland, lymph nodes and bones has been previously described (1). The prognosis in patients with unresectable disease is generally poor with overall survival of 6 to 11 months (3).In the present study, we report, to the best of our knowledge, the first case of primary lung HAC metastasizing to the tonsil.Wide surgical excision, chemotherapy, and radiation therapy (RT) have been used to treat oropharyngeal metastases from solid tumors (4). However, the role of RT for tonsillar metastases has not been previously described. The potential benefits of palliative RT in patients with lung cancer metastasis to the tonsils include mitigation of asphyxiation risk, durable remission, and an improvement in survival (5-7). Thus, RT should be considered a potentially effective treatment for tonsillar metastasis albeit tonsillar metastases portend a poor prognosis with a high likelihood of disease at other sites (5). Case reportA 61-year-old male presenting with left-sided chest pain due to malignant pleural effusion was diagnosed with stage IVA HAC of the lung (Fig. 1). Despite front-line chemotherapy with cisplatin and pemetrexed, he experienced multiple recurrences with metastasis to the lungs, liver, adrenal gland, and spine and received four additional lines of chemotherapy. Forty-five months after diagnosis, the patient complained of a foreign-body sensation in his throat that caused intermittent gagging and a mass was identified in the left palatine tonsillar fossa ( Fig. 2A). He had no systemic complaints except intermittent fatigue and mid-back pain from a metastatic thoracic spine lesion previously treated with RT. Magnetic resonance imaging (MRI) of the neck showed asymmetry of the tonsils (left larger than right), no direct invasion of the tonsillar mass into deeper structures and no cervical lymphadenopathy (Fig. 2B). A fluorodeoxyglucose positron emission tomography ...

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Section: Introductionmentioning

confidence: 99%

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Valle

Thomas

Kim

et al. 2017

Molecular and Clinical Oncology

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“…Recently, the diagnostic criteria for this cancer included the presence of elevated levels of alpha-fetoprotein. However, quite a few studies have shown that AFP is not specific for hepatoid adenocarcinoma of the lung, being more frequently associated to hepatocellular The expression of alpha-fetoprotein is not mandatory for the diagnosis, as long as other immunohistochemical markers of hepatic differentiation are expressed 2,6 . Therefore, the presented case meets criteria for the diagnosis of hepatoid adenocarcinoma of the lung.…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly affected organ is the stomach (63%) but it may affect others, such as ovary (10%), lung (5%), bladder (4%), pancreas (4%) and uterus (4%) 2 . Hepatoid adenocarcinoma of the lung is an extremely rare form, with only 20 cases described 3 .…”

Section: Introductionmentioning

confidence: 99%

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Hepatoid Adenocarcinoma of the Lung

Lucas¹,

Costa²,

Ribeiro³

et al. 2018

Gal. Clin.

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“…Hepatoid carcinomas may also express MOC31 and mCEA, which are infrequently expressed in HCCs. 160 In a recent study on 8 hepatoid carcinomas, Chandan et al 161 demonstrated positive stains for Hep Par 1, Arg-1, GPC3, and AFP in 8 (100%), 5 (62.5%), 4 (50%), and 4 (50%) cases, respectively. Canalicular pCEA pattern was observed in 3 cases (37.5%).…”

Section: Distinction Between Hepatoid Carcinoma and Hccmentioning

confidence: 95%

Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas

Wang¹,

Kim²,

Koo³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Immunomarkers with diagnostic, therapeutic, or prognostic values have been increasingly used to maximize the benefits of clinical management of patients with neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Objectives.— To review the characteristics of immunomarkers that are commonly used in surgical pathology practice for neoplasms of the gastrointestinal tract, liver, biliary tract, and pancreas, and to summarize the clinical usefulness of immunomarkers that have been discovered in recent years in these fields. Data Sources.— Data sources include literature review, authors' research data, and personal practice experience. Conclusions.— Immunohistochemistry is an indispensable tool for the accurate diagnosis of neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Useful immunomarkers are available to help distinguish malignant neoplasms from benign conditions, determine organ origins, and subclassify neoplasms that are morphologically and biologically heterogeneous. Specific immunomarkers are also available to help guide patient treatment and assess disease aggressiveness, which are keys to the success of personalized medicine. Pathologists will continue to play a critical role in the discovery, validation, and application of new biomarkers, which will ultimately improve patient care.

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Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature

Cited by 87 publications

References 18 publications

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Hepatoid Adenocarcinoma of the Lung

Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas

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