α-Fetoprotein-Producing Adenocarcinoma of the Pancreas Presenting Focal Hepatoid Differentiation

Tanno, Satoshi; Obara, Takao; Fujii, Tsuneshi; Izawa, Tsutomu; Mizukami, Yusuke; Saitoh, Yusuke; Ura, Hideki; Kohgo, Yutaka

doi:10.1385/ijgc:26:1:43

Cited by 27 publications

(38 citation statements)

References 19 publications

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“…Review of the literature found only seven cases of hepatoid carcinoma of the pancreas, 13,[38][39][40][41] including the present case (Table 2). In six of these cases, the serum level of PIVKA-II was not measured and tissue staining for PIVKA-II was not described; however, the serum level of AFP was increased in three of four cases in which it was measured, and five of the seven cases were AFP-positive immunohistochemically.…”

Section: Discussionmentioning

confidence: 98%

Hepatoid carcinoma of the pancreas producing protein induced by vitamin K absence or antagonist II (PIVKA-II) and α-fetoprotein (AFP)

et al. 2006

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We describe a rare case of hepatoid carcinoma of the pancreas with production of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP). The patient was a 49-year-old woman admitted because of high serum levels of PIVKA-II (1.63 AU/ml) and AFP (623 ng/ml) and abnormal ultrasonographic findings of the pancreas, found incidentally at medical checkup. Both ultrasonography and computed tomography showed swelling of the pancreas with small areas of low density, but no hepatic lesions. The serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were not increased. A PIVKA-II and AFP-producing pancreatic cancer was strongly suspected, and total pancreatectomy was performed. Pathological examination showed that the tumor cells were arranged in trabecular and solid patterns with bile production, and were immunohistochemically positive for PIVKA-II and AFP, resembling hepatocellular carcinoma cells. The tumor was diagnosed as hepatoid carcinoma of the pancreas, and the patient has survived 48 months after initial diagnosis. It is important that hepatoid carcinoma be considered as a possible malignant tumor of the pancreas, and simultaneous measurement of the serum levels of AFP and PIVKA-II will enable earlier diagnosis. This is the first report describing hepatoid carcinoma of the pancreas producing PIVKA-II.

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Section: Discussionmentioning

confidence: 98%

Hepatoid carcinoma of the pancreas producing protein induced by vitamin K absence or antagonist II (PIVKA-II) and α-fetoprotein (AFP)

et al. 2006

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“…Of the 22 adult cases reported in the literature, 10 (46%) had distant metastases at presentation, 16 (87%) underwent surgery and 9 (41%) died of the disease [2,23,28,33,34,47,48]. The mean survival rate of patients that died of disease was 18 months.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…Pancreatic forms of HC are extremely uncommon, with 22 cases [2,11,19,20,23,24,25,26,28,30,33,34,43,44,45,46,47,48,49] being reported at the time of writing this review. Literature review shows divergent results in terms of survival.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…Complete hepatocyte function following the switch has also been described as the pancreas of adult mice contains hepatocyte progenitor cells capable of significant therapeutic liver reconstruction [22]. Several authors claim this would be the key event of the pancreatic development of HCs [23,24,25,26]. Another pathogenetic mechanism relies on the common origin of pancreatic and liver tissue from the posterior foregut endodermic cells, keeping at a certain point distinct differentiation pathways.…”

Section: Etiology and Cell Originmentioning

confidence: 99%

“…Another pathogenetic mechanism relies on the common origin of pancreatic and liver tissue from the posterior foregut endodermic cells, keeping at a certain point distinct differentiation pathways. Pancreatic multipotent cells normally suppress hepatocytic differentiation genes, which could be activated during tumor genesis or for particular environmental conditions [23]. As previously suggested by other authors, the presence of a common multipotent/stem cell in the coexistence of peculiar environmental conditions (e.g.…”

Section: Etiology and Cell Originmentioning

confidence: 99%

See 2 more Smart Citations

Pancreatic Hepatoid Carcinoma: A Review of the Literature

Marchegiani¹,

Gareer²,

Parisi

et al. 2013

Dig Surg

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Background: Hepatoid carcinomas (HCs) are extrahepatic neoplasms exhibiting features of hepatocellular tumors in terms of morphology and immunohistochemistry. They have been described in several organs, most notably in the stomach and ovary. They can present in pure forms or in association with other morphological aspects, such as endocrine tumors or ductal adenocarcinomas. The aim of this review is to describe aspects of hepatoid adenocarcinoma of the pancreas with regard to epidemiology, diagnosis, and treatment. Methods: The PubMed database was searched for publications addressing hepatoid adenocarcinoma of the pancreas. We have searched for articles including the following keywords: ‘pancreatic hepatoid carcinoma', ‘ectopic liver cancer' and ‘rare pancreas neoplasm' published to date. As references, we used case reports and review articles. Results: Pancreatic forms of HCs are extremely uncommon: only 22 cases have been reported. Conclusions: The possibility of an HC of the pancreas should be considered in the differential diagnosis of an uncommon pathological mass of the pancreas. Treatment seems to be related to the association with other neoplasms, tumor extension at the time of diagnosis and the possibility to perform a radical resection. The common embryologic origin of the pancreas and liver, together with peculiar environmental factors, may explain the development of pancreatic HCs.

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Pancreatic hepatoid carcinoma: A rare form of pancreatic neoplasm

Soofi

Kanehira

Abbas

et al. 2014

Diagnostic Cytopathology

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Primary pancreatic hepatoid carcinoma (PHC) is extremely rare, resembling hepatocellular carcinoma (HCC) in terms of morphology and immunohistochemical features. Hepatoid carcinoma can present in other organs, most noticeably in the stomach. PHC is present in two forms either a pure form like HCC or admixed with other histologic tumor components characteristic of the underlying primary site (endocrine tumors, ductal, or acinar adenocarcinomas). Here, we report a 69-year-old male patient with distal pancreatic mass incidentally found during a CT scan workup for a pulmonary nodule suspicious for metastatic prostate adenocarcinoma. We described the clinical, cytological, and histological finding and conducted a literature review.

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α-Fetoprotein-Producing Adenocarcinoma of the Pancreas Presenting Focal Hepatoid Differentiation

Cited by 27 publications

References 19 publications

Hepatoid carcinoma of the pancreas producing protein induced by vitamin K absence or antagonist II (PIVKA-II) and α-fetoprotein (AFP)

Hepatoid carcinoma of the pancreas producing protein induced by vitamin K absence or antagonist II (PIVKA-II) and α-fetoprotein (AFP)

Pancreatic Hepatoid Carcinoma: A Review of the Literature

Pancreatic hepatoid carcinoma: A rare form of pancreatic neoplasm

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