Hepatoid Adenocarcinoma of the Rectum With Liver Metastasis in a Patient With Ulcerative Colitis

Abstract

Hepatoid adenocarcinoma (HA) is a rare malignant tumor of extrahepatic origin that morphologically and immunophenotypically resembles hepatocellular carcinoma. We report a case of rectal HA with hepatic metastasis arising in a 38-year-old male with a history of ulcerative colitis. Despite elevated alpha-fetoprotein, contrast enhancement of the hepatic mass was not consistent with hepatocellular carcinoma. Immunohistochemistry revealed the diagnosis, and the patient was started on palliative chemotherapy. Colorectal HA should be considered when evaluating malignant lesions in the setting of inflammatory bowel disease and can be distinguished from other tumors based on alpha-fetoprotein, imaging, and immunostaining.

A case report of two instances of colorectal hepatoid adenocarcinoma, accompanied by a comprehensive literature review

“…Herein, we reported two cases of hepatoid adenocarcinoma which occurred in the colon and rectum respectively. Additionally, we collected the data of 37 cases with colorectal hepatoid adenocarcinoma reported in the literature (Wang et al 2016 , 2022 ; Fan et al 2020 ; Zhang et al 2013 , 2005 ; Xu et al 2019a , b , 2015 ; Zhou and Zhao 2019 ; Zhai et al 2015 ; Ge et al 2001 ; Xin et al 2018 ; Hocking et al 1995 ; Kurihara et al 1997 ; Yachida et al 2003 ; Fu et al 2006 ; Anzai et al 2015 ; Taguchi et al 1997 ; Kato et al 1996 ; Jun et al 2016 ; Ishikura et al 1997 ; Armaghani et al 2015 ; Yuanyuan et al 2014 ; Cappetta et al 2012 ; Lattes et al 2000 ; Levy et al 2019 ; Slotta et al 2012 ; Ming et al 2018 ; Borgonovo et al 2008 ; Liu et al 2007 , 2020 ; Sato et al 1994 ). The clinicopathological characteristics of all 39 patients with colorectal hepatoid adenocarcinoma are summarized in Table 1 .…”

“…In the present study, we identified five patients with a combination of inflammatory bowel disease, (one in the colon, three in the rectum, and one in the rectosigmoid junction). Chronic inflammation has been proposed to have a role in this possible association (Levy et al 2019 ). However, there is no literature reporting a specific mechanism linking inflammatory bowel disease to colorectal hepatoid adenocarcinoma.…”