Hepatoid carcinoma of the pancreas: A case report and review of the literature

Zeng, Shao-Xiong; Tan, Siwei; Fong, Christ-Jonathan Tsia Hin; Liang, Qiong; Zhao, Bin-Liang; Liu, Ke; Guo, Jiaxiang; Jin, Tao

doi:10.12998/wjcc.v8.i6.1116

Cited by 13 publications

(10 citation statements)

References 49 publications

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“…Head of the pancreas lesions have been listed as the second most common site of tumor origin after the tail. Furthermore, PHAC is more common in males; females account for 32.5% of reported cases including ours [14]. The liver is the second most metastasis site after lymph nodes, 46.3% and 57.5% respectively [9].…”

Section: Discussionmentioning

confidence: 72%

“…Since then, only a few cases of Pancreatic HAC (PHAC) have been reported and the exact features and behavior of this tumor remain unclear. A recent review published March 2020, reported a total of 39 hepatoid carcinoma cases with pancreatic origins [14]. In our English literature search May 2021, no other PHAC has been described since.…”

Section: Discussionmentioning

confidence: 90%

“…Per Zeng SX et al among all pancreatic carcinomas, 43.58% of have metastasized. Among those, liver involvement was present in 12 out of 17 cases (70.5%) [14]. Usually metastasis is found at the time of presentation but there was a report that after PHAC was removed, liver involvement developed almost a year later [22].…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, PHAC can be divided in two categories; either pure, or a combined type which may contain features of acinar, ductal cell, mucin, neuroendocrine, islet cell glucagonoma, and serous microcystic adenoma. Combined types are less common, have a higher recurrence rate, and worse survival [14,20,21]. Zeng SX et al study identified only 3 cases with ductal component.…”

Section: Discussionmentioning

confidence: 99%

“…HAC with pancreatic origin is extremely rare and the exact incidence is unknown. Owing to its rarity, its clinical course and features are still not fully understood [12][13][14]. It may also be metastatic at presentation, commonly affecting the liver, lymph nodes, and lungs [15].…”

Section: Introductionmentioning

confidence: 99%

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Pancreatic Origin Hepatoid Adenocarcinoma with Liver Metastasis

Salehi¹,

Nwachukwu²,

Grijalva³

et al. 2021

annhematoloncol

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Hepatoid Adenocarcinoma (HAC) is a rare form of aggressive extrahepatic neoplasm with similar morphologic features to Hepatocellular Carcinoma (HCC). HAC with pancreatic origin is rare and the exact incidence is unknown. Given shared morphological and Immunohistochemical (IHC) characteristics, it may be difficult to distinguish metastatic HAC with liver involvement from primary HCC. We present a rare case of ductal type pancreatic hepatoid adenocarcinoma involving the pancreatic head, ampulla of Vater, and liver, and illustrate strategies for diagnosis and treatment. A 65-year-old woman presented with epigastric pain, vomiting, melena, and weight loss. There was direct hyperbilirubinemia with elevated hepatic markers. Imaging displayed a pancreatic head mass with moderate biliary obstruction and a hepatic lobe lesion. Fine needle biopsy of the liver mass initially was consistent with HCC, and biopsies of the pancreatic mass and ampulla walls showed pancreatic adenocarcinoma. Due to the unusual finding of co-existing HCC and pancreatic adenocarcinoma, the hepatic mass biopsy was sent for external evaluation, which revealed poorly differentiated adenocarcinoma, consistent with HAC of pancreatic origin. The tumor was positive for mucicarmine stain, HepPar1, CEA, and CK7. It was negative for MOC-31, Arginase, ALBISH, MGB, ER, TTF-1, GCDFP15, CK-20 and CDX2, thus confirming HAC. The patient was referred to outpatient chemotherapy with gemcitabine and paclitaxel however demonstrated progression and expired following recurrent bilateral pulmonary emboli. HAC may present with non-specific symptoms, is highly aggressive, and may be difficult to distinguish from primary HCC from histopathologic characteristics alone. Accurate diagnosis requires clinicohistopathologic and IHC analysis.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 90%