“…For these two subtypes, IHC results of hepatocyte paraffin (HepPar1/HepPar6) and α-fetoprotein (AFP) usually are both positive ( 36 ). Gurzu et al ( 37 ) proved that the cytoplasmic expression of VSIG1/TTF1 is the pivotal biomarker of the development of gastric-type HCCs and hepatoid carcinomas. It may be a potential biomarker that could be used for differential diagnosis of these two subtypes.…”
BackgroundFindings of ectopic hepatocellular carcinoma (EHCC) have been rarely documented. Complicated clinical features and unpredictable medical prognosis make diagnosis and treatment difficult.Case PresentationWe reported a 59-year-old male patient who came to the hospital with epigastric discomfort and regurgitation of gastric acid. An enhanced CT scan revealed a 1.8 cm × 1.4 cm mass in the tail of pancreas without any positive finding in the liver. Postoperative MRI scan was performed but did not reveal any evidence of hepatic tumor. The tumor was resected in toto. Meanwhile, a 1 cm × 1 cm mass in the body of the stomach was found that was removed simultaneously. Histopathology showed that the pancreatic tumor was ectopic hepatocellular carcinoma (EHCC), and that the gastric nodule was gastrointestinal stromal tumor (GIST). The patient had an uneventful postoperative recovery. He has been living without recurrence for over 7 years since surgery. Owing to our knowledge, this is the second-longest disease-free survival time for EHCC in the literature.ConclusionHere, we present a rare case of EHCC in the pancreas, and review the current literature on EHCC. Operation was an effective treatment for patients with curable EHCC. EHCC with metastasis still needs more practice to improve the poor prognosis.
“…For these two subtypes, IHC results of hepatocyte paraffin (HepPar1/HepPar6) and α-fetoprotein (AFP) usually are both positive ( 36 ). Gurzu et al ( 37 ) proved that the cytoplasmic expression of VSIG1/TTF1 is the pivotal biomarker of the development of gastric-type HCCs and hepatoid carcinomas. It may be a potential biomarker that could be used for differential diagnosis of these two subtypes.…”
BackgroundFindings of ectopic hepatocellular carcinoma (EHCC) have been rarely documented. Complicated clinical features and unpredictable medical prognosis make diagnosis and treatment difficult.Case PresentationWe reported a 59-year-old male patient who came to the hospital with epigastric discomfort and regurgitation of gastric acid. An enhanced CT scan revealed a 1.8 cm × 1.4 cm mass in the tail of pancreas without any positive finding in the liver. Postoperative MRI scan was performed but did not reveal any evidence of hepatic tumor. The tumor was resected in toto. Meanwhile, a 1 cm × 1 cm mass in the body of the stomach was found that was removed simultaneously. Histopathology showed that the pancreatic tumor was ectopic hepatocellular carcinoma (EHCC), and that the gastric nodule was gastrointestinal stromal tumor (GIST). The patient had an uneventful postoperative recovery. He has been living without recurrence for over 7 years since surgery. Owing to our knowledge, this is the second-longest disease-free survival time for EHCC in the literature.ConclusionHere, we present a rare case of EHCC in the pancreas, and review the current literature on EHCC. Operation was an effective treatment for patients with curable EHCC. EHCC with metastasis still needs more practice to improve the poor prognosis.
“…HAC histopathologically and immunohistochemically resembles hepatocellular carcinoma. Recently, Gurzu ( 17 ) developed a hypothesis that the gastric type hepatocellular carcinoma, which shows cytoplasmic VSIG1 expression and hepatoid carcinoma derive from a common stem cell, the VSIG1A-positive foregut pluripotent endodermal cell. The hypothesis offers an explanation for the frequent occurrence of HAC in the foregut-derived organs, namely, the stomach, pancreas, lung, and mediastinum.…”
Hepatoid adenocarcinoma (HAC) is an extremely rare extrahepatic carcinoma, which is pathologically featured by hepatocellular carcinoma (HCC) and marked by producing alpha-fetoprotein (AFP). HAC of mediastinum is extremely rare. For inoperable patients, the curative treatment options have not been established, and the outcome of HAC is usually poor. Here, we present a case of mediastinal HAC with normal serum AFP level who achieved well-controlled and good response after local–regional interventional approach combined with systemic PD-1 inhibitor. A 53-year-old male who complained of chest pain was admitted to our hospital in February 2021. A chest CT scan revealed several tumors in his mediastinum. The laboratory data showed normal serum AFP level. HAC was diagnosed through pathological assessment of biopsy. Surgery was not available due to the infiltration of sternum. Local regional FOLFOX chemotherapy was given by transarterial infusion, followed by transcatheter arterial chemoembolization, and thereafter combined with systemic anti-PD-1 treatment. The patient achieved favorable disease control and apparent symptom relief. So transarterial interventional therapy combined immunotherapy may be a possible and promising treatment for mediastinal HAC.
“…This mechanism might explain why the heterologous GCs were associated with the parameters of aggressiveness and had a poor OS compared to those with homologous patterns. Figure 6 VSIG1-related theory of gastric tumorigenesis—designed based on own data and information from papers of Oidovsambuu et al 12 and Gurzu et al 18 . …”
Section: Discussionmentioning
confidence: 99%
“… VSIG1-related theory of gastric tumorigenesis—designed based on own data and information from papers of Oidovsambuu et al 12 and Gurzu et al 18 . …”
Section: Discussionmentioning
confidence: 99%
“…Since all cases were assessed on TMA blocks, a cut-off value of 15% was used for all the three IHC antibodies, to consider a case as positive. Hepatic tissue served as an external positive control for membrane E-cadherin and β-catenin and for cytoplasmic VSIG1 18 . Normal gastric mucosa was used as a control tissue for membrane VSIG1.…”
V-set and Immunoglobulin domain containing 1 (VSIG1) is a cell–cell adhesion molecule which role in the genesis and evolution of gastric cancer (GC) is not understood. Only three Medline-indexed papers have focused on the role of VSIG1 in GC. The clinicopathological features of 94 GCs were examined in association with immunohistochemical (IHC) patterns of VSIG1, E-cadherin, and β-catenin which were assessed in the tumor core (central) vs. invasive edge. Cases were classified depending on the VSIG1 expression: membrane/membrane in both core and invasive front; null/negative staining in both core and invasive front; and cases with translocational patterns: membrane core/cytoplasmic buds and cytoplasmic core/null buds. Most of the tumors showed null pattern (n = 54). Cases with translocational patterns (n = 20) were GCs with a high lymph node ratio value (≥ 0.26) and advanced Dukes-MAC-like stage. Of the 20 total cases, 9 showed membrane-to-nuclear translocation of β-catenin and loss of E-cadherin, as indicators of epithelial–mesenchymal transition. All cases with membrane/membrane pattern (n = 20) involved the distal stomach. The poorest overall survival was registered in patients with subcellular translocation of VSIG1, compared to those with either membrane/membrane or null patterns (p = 0.002). In GC, VSIG1 acts as an adhesion membrane protein but its membrane-cytoplasmic translocation can be an indicator of epithelial–mesenchymal transition due to cytoplasmic VSIG1-mediated activation of canonical Wnt/β-catenin signaling pathway.
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