1
|
Wang T, Li W, Wang Z, Wei X. A 47-year-old female with primary hepatoid adenocarcinoma in the pelvic retroperitoneum. Quant Imaging Med Surg 2023; 13:6317-6322. [PMID: 37711805 PMCID: PMC10498198 DOI: 10.21037/qims-22-1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/31/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Tao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Nuclear Medicine, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Weihua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
2
|
Han L, Ding N, Li L, Wei X, Hu J, Liu B, Qian X. Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review. Front Oncol 2022; 12:948892. [PMID: 36003790 PMCID: PMC9393733 DOI: 10.3389/fonc.2022.948892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Hepatoid adenocarcinoma of the duodenum is a rare special type of adenocarcinoma, featured by hepatocyte components in primary adenocarcinoma of the duodenum. It has the characteristics of high malignancy, invasiveness, rapid progress, and poor prognosis. An abnormal elevation of serum alpha-fetoprotein (AFP) may occur in most cases. The diagnosis is mainly based on pathological morphology. Here, we reported a case of hepatic adenocarcinoma of the duodenum. The middle-aged female patient had an ampulla mass at diagnosis and received radical pancreaticoduodenectomy. The postoperative pathology was stage IIIA duodenal adenocarcinoma. At 1 month after surgery, she had multiple intrahepatic metastases and retroperitoneal lymph node metastasis; the AFP level was 300 ng/ml at that time. As she refused target therapy, two cycles of capecitabine-oxaliplatin (XELOX) chemotherapy were performed. However, the AFP elevated from 300 to 1,931.90 ng/ml, and the disease progressed rapidly. Immunohistochemistry (IHC) of tissue samples from presurgical endoscopic ultrasound guided fine needle aspiration (EUS-FNA), surgery, and liver biopsy showed positive AFP staining. Combining the abnormal elevation of serum AFP and microscopic pathological morphology, this case is diagnosed as hepatoid adenocarcinoma of the duodenum with liver metastasis. The physical condition of this patient was too poor to receive follow-up treatment. She died of the rapid disease progression with an overall survival time of 161 days. Considering that in most patients with hepatoid adenocarcinoma the abnormal elevation of serum AFP occurs preoperatively and returns to normal postoperatively rather than normal before surgery and increased after surgery, the primary lesion is located in the stomach rather than the intestine, and the patients are more often older men rather than middle-aged women; this case is rare particularly. Therefore, reporting this case with complete case data may be helpful to further study, so as to improve the understanding of this special type of malignant tumor.
Collapse
Affiliation(s)
- Lu Han
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Naiqing Ding
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Li Li
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiao Wei
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jing Hu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Baorui Liu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaoping Qian
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- *Correspondence: Xiaoping Qian,
| |
Collapse
|
3
|
Karakuchi N, Toyota K, Kajikawa R, Watanabe A, Saito Y, Inoue M, Ohmori I, Miyamoto K, Ikeda M, Sadamoto S, Mandai K, Takahashi T. Alpha-fetoprotein-producing Colon Carcinoma with Rapidly Increasing Liver Metastases That Resulted in Death: A Case Report. JOURNAL OF THE ANUS RECTUM AND COLON 2021; 5:100-106. [PMID: 33537504 PMCID: PMC7843138 DOI: 10.23922/jarc.2020-038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022]
Abstract
Alpha-fetoprotein (AFP) has been widely used as a tumor marker for detecting hepatocellular carcinoma and yolk sac tumors. Recently, cases of gastrointestinal cancer with elevated serum AFP levels have been reported. However, AFP-producing colon cancer is considered rarer than other AFP-producing gastrointestinal cancers. In this study, we report on a case of a 47-year-old woman who was diagnosed with sigmoid colon cancer and underwent sigmoidectomy and lymph node dissection. Postoperative adjuvant chemotherapy (AC) was performed after the curative surgery. After the seventh course of AC, multiple liver masses and enlarged systemic lymph nodes were detected; these were later diagnosed as liver metastases from sigmoid colon cancer. Laboratory examination revealed high AFP levels (14,657.8 ng/mL). After confirming the recurrence, her condition worsened rapidly, and she eventually died 8 months after the operation. Autopsy and histopathological findings showed that the liver mass was positive for AFP staining, but the sigmoid colon cancer tissue was not. We then determined that liver metastases of the colon cancer were more likely than germ cell carcinoma according to the clinical course and pathological findings. We assumed that colon cancer cells can rapidly expand by dedifferentiation, and we diagnosed AFP-producing colon cancer with liver metastases. Despite curative surgery and AC for AFP-producing colon cancer, the patient died of liver and systemic lymph node metastases.
Collapse
Affiliation(s)
- Nozomi Karakuchi
- Department of Surgery, Yoshida General Hospital, Akitakata, Japan
| | - Kazuhiro Toyota
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Ryujiro Kajikawa
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Atsuhiro Watanabe
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Yasufumi Saito
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Masashi Inoue
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Ichiro Ohmori
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Kazuaki Miyamoto
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Masahiro Ikeda
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Seiji Sadamoto
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Koichi Mandai
- Department of Pathology, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Tadateru Takahashi
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan.,Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
4
|
Wang W, Li G. Incidence and prognostic factors of hepatoid adenocarcinoma: a population-based analysis. Transl Cancer Res 2020; 9:5401-5410. [PMID: 35117905 PMCID: PMC8798184 DOI: 10.21037/tcr-20-1126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/17/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hepatoid adenocarcinoma (HAC) is a kind of rare extrahepatic adenocarcinoma with hepatocyte differentiation. At present, the incidence and prognostic factors of HAC remain poorly discussed. METHODS We extracted two cohorts from Surveillance, Epidemiology, and End Results (SEER) database by restricting the histology to HAC. One cohort of 258 eligible patients was from SEER 21 Regs Limited-Field Research Data + Hurricane Katrina Impacted Louisiana Cases [2000-2016] to compute incidence, and the other cohort of 121 eligible patients was from SEER 18 Regs Custom Data (with additional treatment fields) [1975-2016] to estimate survival and risk factors. The incidence wad computed by the Joinpoint Regression Program (Version 4.7.0.0). The overall survival (OS) and prognostic factors were analyzed by univariate and multivariate analyses in SPSS 24.0. RESULTS The overall incidence of HAC between 2000 and 2016 was 0.014 per 100,000 people (95% CI: 0.012 to 0.015). The most common primary site was the lung, followed by the digestive, urinary and reproductive organs, but in the previously published case reports, the stomach was the most common site. The median age at diagnosis was 66 (range, 31-85) years. A total of 28.1% of patients underwent surgery, while 71.9% underwent radiotherapy or/and chemotherapy. The 1-year survival rate of these patients was 35.0%, and the 3-year survival rate was only 16.9%. The median survival time was 5 months (95% CI: 2.97 to 7.03 months). Multivariate analysis showed that age less than 60 years, no distant metastasis, surgery and chemotherapy were independent prognostic factors related to a better outcome. CONCLUSIONS This study suggests that HAC is a rare malignant tumor with poor prognosis, and its most common site is lung. Its incidence is increasing year by year. Age at diagnosis, distant metastases, surgery, and chemotherapy were independent prognostic factors.
Collapse
Affiliation(s)
- Wenting Wang
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China
| | - Guang Li
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China
| |
Collapse
|
5
|
|
6
|
WITHDRAWN: Hepatoid adenocarcinoma of the lung accompanied with multiple systemic metastases: An individual case report and literature review. Respir Med Case Rep 2020. [DOI: 10.1016/j.rmcr.2020.101085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
7
|
Søreide JA. Therapeutic Approaches to Gastric Hepatoid Adenocarcinoma: Current Perspectives. Ther Clin Risk Manag 2019; 15:1469-1477. [PMID: 31920320 PMCID: PMC6934111 DOI: 10.2147/tcrm.s204303] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/13/2019] [Indexed: 12/13/2022] Open
Abstract
Hepatoid adenocarcinoma of the stomach (HAS) is a rare subgroup of gastric cancer (GC). Morphologically, this tumor exhibits both adenocarcinomatous and hepatocellular differentiation, and most tumors show immunohistochemical staining for alpha-fetoprotein (AFP) or elevated AFP serum levels. The diagnosis of HAS is frequently delayed, and at least half of patients have advanced disease at the time of diagnosis. Despite a lack of evidence, treatment approaches have mostly followed principles for the treatment of common gastric cancer (CGC), including radical surgery in eligible patients with curative intent. The indications for and the type of adjuvant systemic treatments remain unclear. Additionally, there is a lack of evidence allowing any firm conclusions to be drawn regarding the best treatment for patients with metastatic HAS (mHAS). Chemotherapy regimens, including cisplatin-based chemotherapy, are considered the most efficient first-line systemic treatment in advanced situations. Their combination with targeted therapy (i.e., trastuzumab) in HER2-positive tumors seems promising. The rarity of these patients and the scarce and heterogeneous literature on this particular subgroup of GC make it difficult to provide any robust evidence for the clinical management of patients with HAS.
Collapse
Affiliation(s)
- Jon Arne Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|
8
|
Kiyozawa D, Shimokama T, Kinjo M, Ishikawa M. Hepatoid adenocarcinoma of distal ileum without inflammatory bowel disease; A rare case. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2019.200328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
9
|
Remo A, Fassan M, Vanoli A, Bonetti LR, Barresi V, Tatangelo F, Gafà R, Giordano G, Pancione M, Grillo F, Mastracci L. Morphology and Molecular Features of Rare Colorectal Carcinoma Histotypes. Cancers (Basel) 2019; 11:cancers11071036. [PMID: 31340478 PMCID: PMC6678907 DOI: 10.3390/cancers11071036] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 02/05/2023] Open
Abstract
Several histopathological variants of colorectal carcinoma can be distinguished, some associated with specific molecular profiles. However, in routine practice, ninety/ninety-five percent of all large bowel tumors are diagnosed as conventional adenocarcinoma, even though they are a heterogeneous group including rare histotypes, which are often under-recognized. Indeed, colorectal cancer exhibits differences in incidence, location of tumor, pathogenesis, molecular pathways and outcome depending on histotype. The aim is therefore to review the morphological and molecular features of these rare variants of intestinal carcinomas which may hold the key to differences in prognosis and treatment.
Collapse
Affiliation(s)
- Andrea Remo
- Pathology Unit, Services Department, ULSS9 "Scaligera", 37122 Verona, Italy.
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, 35100 Padua, Italy
| | - Alessandro Vanoli
- Unit of Anatomic Pathology, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Luca Reggiani Bonetti
- Department of Diagnostic, Clinic and Public Health Medicine, Anatomic Pathology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Valeria Barresi
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy
| | - Fabiana Tatangelo
- Department of Pathology, Istituto Nazionale Tumori Fondazione G. Pascale, IRCCS, 80131 Naples, Italy
| | - Roberta Gafà
- Section of Anatomic Pathology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara and S. Anna University Hospital, 44121 Ferrara, Italy
| | - Guido Giordano
- U.O.C. Oncologia Medica, Ospedali Riuniti Azienda Ospedaliera Universitaria, 71122 Foggia, Italy
| | - Massimo Pancione
- Department of Sciences and Technologies, University of Sannio, 82100 Benevento, Italy
| | - Federica Grillo
- Anatomic Pathology, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa and Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Luca Mastracci
- Anatomic Pathology, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa and Ospedale Policlinico San Martino, 16132 Genoa, Italy
| |
Collapse
|
10
|
Ren F, Weng W, Zhang Q, Tan C, Xu M, Zhang M, Wang L, Sheng W, Ni S, Huang D. Clinicopathological features and prognosis of AFP-producing colorectal cancer: a single-center analysis of 20 cases. Cancer Manag Res 2019; 11:4557-4567. [PMID: 31191017 PMCID: PMC6529609 DOI: 10.2147/cmar.s196919] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/12/2019] [Indexed: 12/22/2022] Open
Abstract
Background: High serum levels of alpha-fetoprotein (AFP) are observed in some gastrointestinal cancers. However, primary AFP-producing colorectal cancer (CRC) is extremely rare and causes confusion among clinicians. In this study, we analyzed the clinicopathological features and clinical outcomes of AFP-producing CRC and provide a brief view of this rare carcinoma. Patients and methods: Twenty patients with AFP-producing CRC were enrolled at the Fudan University Shanghai Cancer Center from 2012 to 2015. Clinical information, including serum AFP and CEA levels, and outcomes were collected. Tumors were divided into three histologic types: the common adenocarcinoma (COM) type, mucinous adenocarcinoma type and hepatoid type (HPT). Immunohistochemical (IHC) staining of GPC3, Hepa-1, SALL4 and Arg-1 was performed. Additionally, mutations of the KRAS, NRAS and BRAF genes were examined. Finally, another 40 stage-matched patients with traditional CRC were enrolled as controls for survival analysis. Results: AFP-producing CRC was more likely to occur in males (60%) and arose mainly from the ascending (40%) and sigmoid (35%) colon. In addition, the majority of patients with AFP-producing CRC had poor differentiation (50%), advanced local invasion (80%) and lymph node (LN) metastasis (60%). Synchronous distant metastasis was commonly observed (35%). Interestingly, serum AFP levels were closely associated with LN metastasis. Histopathologically, the COM type was the most common pattern. In IHC staining, the HPT pattern was the most distinct due to high positivity rates of GPC3, Hepa-1 and Arg-1. One patient had mismatch repair deficiency, and another had a KRAS mutation. Patients with AFP-producing CRC had worse progression-free and overall survival than patients with traditional CRC. Conclusion: AFP-producing CRC has unique clinical and histopathological characteristics, showing an aggressive biological behavior and worse prognosis than traditional CRC.
Collapse
Affiliation(s)
- Fei Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Weiwei Weng
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Qiongyan Zhang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Cong Tan
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Midie Xu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Meng Zhang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Lei Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Weiqi Sheng
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Shujuan Ni
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Dan Huang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| |
Collapse
|
11
|
Hepatoid Adenocarcinoma With Enteroblastic Differentiation in the Sigmoid Colon: Lessons From a Rare Case. Am J Gastroenterol 2019; 114:684-685. [PMID: 30848729 DOI: 10.14309/ajg.0000000000000176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
12
|
Huang J, Zhu R, Wu R, Li R, Yao N, Deng S. Hepatoid adenocarcinoma of the renal pelvis in a 59-year-old male with nephrolithiasis: Case report and review of the literature. Curr Probl Cancer 2019; 43:471-476. [PMID: 30683324 DOI: 10.1016/j.currproblcancer.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 11/21/2018] [Accepted: 12/21/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hepatoid adenocarcinoma arising from urological system is extremely rare, and the pathogenesis and therapeutic regimen have been poorly understood. CASE REPORT we report a unique case of ɑ-fetaprotein (AFP)-producing neoplasm of renal pelvis associated with nephrolithiasis. A 59-year-old male patient was diagnosed with right renal tumor and nephrolithiasis with no evidence of lesions in his digestive or reproductive system. He was successfully treated with right laparoscopic radical nephroureterectomy and lymph node dissection. Pathology analysis showed moderately or poorly hepatocellular differentiation and adenocarcinoma differentiation with lymph node reactive hyperplasia. Immunohistochemical analysis demonstrated that the cancer cells were positive for AFP, HepPar-1, GPC3, CK7, and PLAP. The patient's recovery was on schedule and no sign of recurrence was observed for 3 months. We recently reviewed AFP-producing nongerm cell tumors in upper urinary tract and discussed the clinical aspect, morphology features, pathogenesis, and therapeutic regimen for a better understanding of this rare entity. CONCLUSION The present case is the first documented of hepatoid adenocarcinoma of renal pelvis complicated with nephrolithiasis, which was treated with laparoscopic approach. The prognosis of the hepatoid adenocarcinomas arising from renal pelvis and ureter seems good.
Collapse
Affiliation(s)
- Jun Huang
- Department of Urology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of SUN YAT-SEN University, Jiangmen, Guangdong, China
| | - Ruilong Zhu
- Department of Urology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of SUN YAT-SEN University, Jiangmen, Guangdong, China.
| | - Ronghai Wu
- Department of Urology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of SUN YAT-SEN University, Jiangmen, Guangdong, China
| | - Ronggang Li
- Department of Pathology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of SUN YAT-SEN University, Jiangmen, Guangdong, China
| | - Nan Yao
- Department of Radiology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of SUN YAT-SEN University, Jiangmen, Guangdong, China
| | - Shuo Deng
- Department of Urology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of SUN YAT-SEN University, Jiangmen, Guangdong, China
| |
Collapse
|
13
|
Lin J, Cao Y, Yu L, Lin L. Non-α-fetoprotein-producing adrenal hepatoid adenocarcinoma: A case report and literature review. Medicine (Baltimore) 2018; 97:e12336. [PMID: 30278510 PMCID: PMC6181627 DOI: 10.1097/md.0000000000012336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
RATIONALE Adrenal hepatoid adenocarcinoma typically secretes alpha-fetoprotein (AFP). Here, we report a case of non-AFP-producing adrenal hepatoid adenocarcinoma. Next-generation sequencing (NGS) was conducted to identify gene mutations. PATIENT CONCERNS A 64-year-old man presented with mild back pain and unexplained weight loss for 3 months. DIAGNOSES Contrast-enhanced magnetic resonance imaging (MRI) showed a mass (9.9 × 9.7 × 9.1 mm) above the upper pole of the left kidney. The left renal artery and vein were compressed. The tumor was positive for CK8/18, CK19, CK7, hepatocyte marker (Hepatocyte), and Hep Par 1, but negative for AFP. Plasma AFP was 2.75 ng/mL (normal range: 0-7 ng/mL). NGS revealed mutations of the following genes: ATM, CDKN2A, EGFR, STK11, TP53, BIM, and MLH1. A diagnosis of adrenal hepatoid adenocarcinoma was established. INTERVENTIONS The treatment included 4 cycles of the mFOLFOX6 regimen (oxaliplatin, leucovorin, and fluorouracil), transcatheter arterial chemoembolization, and apatinib. OUTCOMES The patient died 9 months after the diagnosis. LESSONS This case highlights the importance of thorough clinical, radiological, and immunohistochemical investigation for suspected adrenal hepatoid adenocarcinoma. Metastasis from other primary tumors should be ruled out. Furthermore, AFP is not necessarily elevated in adrenal hepatoid adenocarcinoma. NGS could be helpful in establishing the diagnosis and selecting treatments.
Collapse
|