Hepatoid adenocarcinoma in the peritoneal cavity

Rationale: Hepatoid adenocarcinoma (HAC) is a rare extrahepatic adenocarcinoma that histologically resembles hepatocellular carcinoma (HCC). HAC of peritoneal cavity can present as a solitary mass or disseminated nodules indicating different treatment. Patient concerns: In this study, we present the cases of a 29-year-old man and a 64-year-old woman who suffered from HAC. Diagnosis: The serum alpha-fetoprotein (AFP) of both patients and ascites of 1 patient were markedly elevated. One patient presented with multiple nodular disseminated in the peritoneal cavity and the other patient has a mass between the left diaphragm and the spleen on computed tomography and magnetic resonance imaging. Intervention: The first patient underwent laparoscopic examination and multiple nodules were found in the peritoneal cavity, and only received chemotherapy. The second patient underwent surgery and resected the mass between left diaphragm and the spleen. Outcome: Histological examinations showed the nodule of the peritoneal cavity and mass belong to moderately differentiated HCC. HAC has a poor prognosis, but the 2 patients responded well to treatment. Lesson: HAC is frequently associated with elevated serum AFP without neoplasm in the liver. Histological and Immunohistochemistry examinations can help differential diagnosis.

[1]  Chun-Ying Wu,et al.  Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. , 2013, World journal of gastroenterology.

[2]  Manasi S Shah,et al.  Hepatoid adenocarcinoma of the peritoneal cavity: Prolonged survival after debulking surgery and 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX) therapy. , 2012, Journal of gastrointestinal oncology.

[3]  A. Reiter,et al.  Hepatoid Adenocarcinoma – Review of the Literature Illustrated by a Rare Case Originating in the Peritoneal Cavity , 2010, Oncology Research and Treatment.

[4]  M. Tsushima,et al.  Hepatoid carcinoma of the skin: spontaneous rat skin hepatoid carcinoma with eosinophilic globules and crystals immunoreactive to α-1-antitrypsin , 2009, Medical Molecular Morphology.

[5]  F. Ciardiello,et al.  Hepatoid carcinoma colliding with a liposarcoma of the left colon serosa presenting as an abdominal mass , 2007, World Journal of Surgical Oncology.

[6]  T. Chiba,et al.  Diffuse hepatoid adenocarcinoma in the peritoneal cavity. , 2006, Internal medicine.

[7]  R. Gopaldas,et al.  Hepatoid malignancy of unknown origin--a diagnostic conundrum: review of literature and case report of collision with adenocarcinoma. , 2005, Surgical oncology.

[8]  H. Ishikura,et al.  Hepatoid adenocarcinoma: A distinctive histological subtype of alpha-fetoprotein-producing lung carcinoma , 2005, Virchows Archiv A.

[9]  Sang Woo Park,et al.  Hepatocellular carcinoma in an ectopic Liver: CT findings , 2003, European Radiology.

[10]  H. Ishikura,et al.  An AFP‐producing gastric carcinoma with features of hepatic differentiation. A case report , 1985, Cancer.

[11]  A. Fondimare,et al.  [Existence of alpha feto protein during gastric-origin secondary cancer of the liver]. , 1970, La Presse medicale.