A 37-year old female patient suffering from an upper abdominal pain, accompanied by recent emaciation and anorexia that resulted from a two-month epigastric lump, visited a doctor in our hospital in January, 2007. Phy...A 37-year old female patient suffering from an upper abdominal pain, accompanied by recent emaciation and anorexia that resulted from a two-month epigastric lump, visited a doctor in our hospital in January, 2007. Physical examination of the patient by palpation identified a 10.0 × 8.0 cm^2 lump from the xiphoid process above the middle and superior abdomen. The lesion was hard with a rough surface, the upper boundary unsharp, and the inferior and right boundary clearly apparent. The pain at the site of the lump was only apparent with touching at that site.展开更多
BACKGROUND Hepatoid carcinoma(HC)is an extremely rare neoplasm that is morphologicallysimilar to hepatocellular carcinoma.HC has been described in various organs;however,HC of the pancreas is extremely rare.To our kno...BACKGROUND Hepatoid carcinoma(HC)is an extremely rare neoplasm that is morphologicallysimilar to hepatocellular carcinoma.HC has been described in various organs;however,HC of the pancreas is extremely rare.To our knowledge,only 38 caseshave been reported.We present a case of HC of the pancreas in a 36-year-oldmale patient.CASE SUMMARY A 36-year-old cachexic man with no significant past medical history wastransferred to our hospital with a history of painless jaundice,elevated bloodglucose and significant weight loss.Lab tests showed elevated serumtransaminases,bilirubin and alpha-fetoprotein levels.Magnetic resonanceimaging of the upper abdomen showed a diffusely enlarged pancreas,appearing“sausage-shaped”.Magnetic resonance cholangiopancreatography showedupstream ductal dilation secondary to stricture of the main pancreatic duct andthe common bile duct,which were not visible.Immunohistochemistry ofbiopsied tissue from a percutaneous pancreatic biopsy showed tumor cellpositivity for HepPar1,polyclonal carcinoembryonic antigen and CK19,suggestive of HC of the pancreas.The characteristics of 39 patients with HC ofthe pancreas were reviewed.CONCLUSION HC of the pancreas is more prevalent in males,and patients have a median age of57 years.It is most commonly asymptomatic or presents as abdominal back pain,and the pancreatic tail is the most common location.At the time of diagnosis,liver metastasis is often present.展开更多
In 1970, a gastric adenocarcinoma patient with increased alpha fetoprotein （AFP） in his serum and liver metastatic tumor was reported by Bourreilile et al. At that time, it was realized that a gastric adenocarcinoma...In 1970, a gastric adenocarcinoma patient with increased alpha fetoprotein （AFP） in his serum and liver metastatic tumor was reported by Bourreilile et al. At that time, it was realized that a gastric adenocarcinoma could produce AFP. In 1985, Ishikura et al reported a hepatocellular carcinoma （HCC）-like differentiation in a primary gastric tumor and first proposed the conception of a ＂hepatoid carcinoma＂. Subsequent documentation of this unique histopathologic feature has been made in other extrahepatic sites including the esophagus, papilla of Vater, colon, lung, gallbladder, adrenal gland, kidney, urinary bladder, ovary, uterus, vagina, testicle, and small intestine. However, the number of cases is very small. Hepatoid carcinoma is a primary extrahepatic neoplasm exhibiting features of hepatocellular carcinoma in terms of morphology, immunohistochemistry and biological behavior. But histopathologically it is very rare. Many but not all cases, present with an elevated serum AFP. Taking a wide view of various literatures it is evident that hepatoid carcinoma has mostly been found in the stomach and very rarely in the pancreas. To date, only eight cases of hepatoid carcinoma of the pancreas have been reported in the literature. We present a case of hepatoid carcinoma of the pancreas arising in an elderly man without evidence of residual disease eight months after local resection of the tumor.展开更多
AIM: To evaluate the dynamic computed tomography(CT) findings of liver metastasis from hepatoid adenocarcinoma of the stomach(HAS) and compared them with hepatocellular carcinoma(HCC).METHODS: Between January 2000 and...AIM: To evaluate the dynamic computed tomography(CT) findings of liver metastasis from hepatoid adenocarcinoma of the stomach(HAS) and compared them with hepatocellular carcinoma(HCC).METHODS: Between January 2000 and January 2015, 8 patients with pathologically proven HAS and liver metastases were enrolled. Basic tumor status was evaluated for the primary tumor location and metastatic sites. The CT findings of the liver metastases were analyzed for tumor number and size, presence of tumor necrosis, hemorrhage, venous tumor thrombosis, and dynamic enhancing pattern.RESULTS: The body and antrum were the most common site for primary HAS(n = 7), and observed metastatic sites included the liver(n = 8), lymph nodes(n = 7), peritoneum(n = 4), and lung(n = 2). Most of the liver metastases exhibited tumor necrosis regardless of tumor size. By contrast, tumor hemorrhage was observed only in liver lesions larger than 5 cm(n = 4). Three patterns of venous tumor thrombosis were identified: direct venous invasion by the primary HAS(n = 1), direct venous invasion by the liver metastases(n = 7), and isolated portal vein tumor thrombosis(n = 2). Dynamic CT revealed arterial hyperattenuation and late phase washout in all the liver metastases.CONCLUSION: On dynamic CT, liver metastasis from HAS shared many imaging similarities with HCC. For liver nodules, the presence of isolated portal vein tumor thrombosis and a tendency for tumor necrosis are imaging clues that suggest the diagnosis of HAS.展开更多
Protein induced by vitamin K absence or antagonist Ⅱ(PIVKA-Ⅱ) is a putative specific marker of hepatocellular carcinoma(HCC),but it may also be produced by asmall number of gastric cancers.To date,16 cases of PIVKA-...Protein induced by vitamin K absence or antagonist Ⅱ(PIVKA-Ⅱ) is a putative specific marker of hepatocellular carcinoma(HCC),but it may also be produced by asmall number of gastric cancers.To date,16 cases of PIVKA-Ⅱ-producing gastric cancer have been reported,2 of which were reported by us and all of which were identified in Japan.There are no symptoms specific to PIVKA-Ⅱ-producing gastric cancer,and the representative clinical symptoms are general fatigue,appetite loss,and upper abdominal pain.Serum alpha-feto-protein(AFP)levels are also increased in almost allcases.Liver metastasis is observed in approximately 80% of cases and portal vein tumor thrombus is ob-served in approximately 20% of cases.Differential diagnosis between metastatic liver tumor and HCC is often difficult.Grossly,almost all cases appear as advanced gastric cancer.Histologically,a hepatoid pattern is observed in many cases,in addition to a moderately to poorly differentiated adenocarcinoma component.The production of PIVKA-Ⅱ and AFP is usually confirmed using immunohistochemical staining.Treatment and prognosis largely depends on the existence of liver meta-stasis,and the prognosis of patients with liver metas-tasis is very poor.PIVKA-Ⅱ may be produced during the hepatocellular metaplasia of the tumor cells.展开更多
1前言肝细胞样癌是一种肝外器官或组织中发生的具有肝细胞样结构和形态学特征的腺癌。肝细胞样癌最初被描述为可以产生甲胎蛋白(alpha-fetoprotein,AFP)的肿瘤^([1])。最早在1985年,Ishikura等^([2])报道了具有肝细胞癌样分化的胃癌病例...1前言肝细胞样癌是一种肝外器官或组织中发生的具有肝细胞样结构和形态学特征的腺癌。肝细胞样癌最初被描述为可以产生甲胎蛋白(alpha-fetoprotein,AFP)的肿瘤^([1])。最早在1985年,Ishikura等^([2])报道了具有肝细胞癌样分化的胃癌病例,患者血清及肿瘤组织中的AFP水平均明显增高,由此提出了胃肝细胞样癌的概念。1987年,Ishikura等^([3])首次报道了卵巢肝细胞样癌(hepatoid carcinoma of the ovary,HCO)的病例,至今文献报道不足50例^([4])。此外,肝细胞样癌还可发生于其他组织器官,如肠道、胰腺、胆囊、肺、膀胱、肾脏、子宫等。其中,胃是最常见的发生部位,而卵巢在生殖系统中最为常见^([5-11])。展开更多
文摘A 37-year old female patient suffering from an upper abdominal pain, accompanied by recent emaciation and anorexia that resulted from a two-month epigastric lump, visited a doctor in our hospital in January, 2007. Physical examination of the patient by palpation identified a 10.0 × 8.0 cm^2 lump from the xiphoid process above the middle and superior abdomen. The lesion was hard with a rough surface, the upper boundary unsharp, and the inferior and right boundary clearly apparent. The pain at the site of the lump was only apparent with touching at that site.
基金the National Natural Science Foundation for Young Scientists of China,No.81800458the Science and Technology Planning Project of Guangdong Province,No.2016A020216014the Basic Research Program of Young Teachers’Training Project of Sun Yat-Sen University,No.17ykpy52.
文摘BACKGROUND Hepatoid carcinoma(HC)is an extremely rare neoplasm that is morphologicallysimilar to hepatocellular carcinoma.HC has been described in various organs;however,HC of the pancreas is extremely rare.To our knowledge,only 38 caseshave been reported.We present a case of HC of the pancreas in a 36-year-oldmale patient.CASE SUMMARY A 36-year-old cachexic man with no significant past medical history wastransferred to our hospital with a history of painless jaundice,elevated bloodglucose and significant weight loss.Lab tests showed elevated serumtransaminases,bilirubin and alpha-fetoprotein levels.Magnetic resonanceimaging of the upper abdomen showed a diffusely enlarged pancreas,appearing“sausage-shaped”.Magnetic resonance cholangiopancreatography showedupstream ductal dilation secondary to stricture of the main pancreatic duct andthe common bile duct,which were not visible.Immunohistochemistry ofbiopsied tissue from a percutaneous pancreatic biopsy showed tumor cellpositivity for HepPar1,polyclonal carcinoembryonic antigen and CK19,suggestive of HC of the pancreas.The characteristics of 39 patients with HC ofthe pancreas were reviewed.CONCLUSION HC of the pancreas is more prevalent in males,and patients have a median age of57 years.It is most commonly asymptomatic or presents as abdominal back pain,and the pancreatic tail is the most common location.At the time of diagnosis,liver metastasis is often present.
文摘In 1970, a gastric adenocarcinoma patient with increased alpha fetoprotein （AFP） in his serum and liver metastatic tumor was reported by Bourreilile et al. At that time, it was realized that a gastric adenocarcinoma could produce AFP. In 1985, Ishikura et al reported a hepatocellular carcinoma （HCC）-like differentiation in a primary gastric tumor and first proposed the conception of a ＂hepatoid carcinoma＂. Subsequent documentation of this unique histopathologic feature has been made in other extrahepatic sites including the esophagus, papilla of Vater, colon, lung, gallbladder, adrenal gland, kidney, urinary bladder, ovary, uterus, vagina, testicle, and small intestine. However, the number of cases is very small. Hepatoid carcinoma is a primary extrahepatic neoplasm exhibiting features of hepatocellular carcinoma in terms of morphology, immunohistochemistry and biological behavior. But histopathologically it is very rare. Many but not all cases, present with an elevated serum AFP. Taking a wide view of various literatures it is evident that hepatoid carcinoma has mostly been found in the stomach and very rarely in the pancreas. To date, only eight cases of hepatoid carcinoma of the pancreas have been reported in the literature. We present a case of hepatoid carcinoma of the pancreas arising in an elderly man without evidence of residual disease eight months after local resection of the tumor.
文摘AIM: To evaluate the dynamic computed tomography(CT) findings of liver metastasis from hepatoid adenocarcinoma of the stomach(HAS) and compared them with hepatocellular carcinoma(HCC).METHODS: Between January 2000 and January 2015, 8 patients with pathologically proven HAS and liver metastases were enrolled. Basic tumor status was evaluated for the primary tumor location and metastatic sites. The CT findings of the liver metastases were analyzed for tumor number and size, presence of tumor necrosis, hemorrhage, venous tumor thrombosis, and dynamic enhancing pattern.RESULTS: The body and antrum were the most common site for primary HAS(n = 7), and observed metastatic sites included the liver(n = 8), lymph nodes(n = 7), peritoneum(n = 4), and lung(n = 2). Most of the liver metastases exhibited tumor necrosis regardless of tumor size. By contrast, tumor hemorrhage was observed only in liver lesions larger than 5 cm(n = 4). Three patterns of venous tumor thrombosis were identified: direct venous invasion by the primary HAS(n = 1), direct venous invasion by the liver metastases(n = 7), and isolated portal vein tumor thrombosis(n = 2). Dynamic CT revealed arterial hyperattenuation and late phase washout in all the liver metastases.CONCLUSION: On dynamic CT, liver metastasis from HAS shared many imaging similarities with HCC. For liver nodules, the presence of isolated portal vein tumor thrombosis and a tendency for tumor necrosis are imaging clues that suggest the diagnosis of HAS.
文摘Protein induced by vitamin K absence or antagonist Ⅱ(PIVKA-Ⅱ) is a putative specific marker of hepatocellular carcinoma(HCC),but it may also be produced by asmall number of gastric cancers.To date,16 cases of PIVKA-Ⅱ-producing gastric cancer have been reported,2 of which were reported by us and all of which were identified in Japan.There are no symptoms specific to PIVKA-Ⅱ-producing gastric cancer,and the representative clinical symptoms are general fatigue,appetite loss,and upper abdominal pain.Serum alpha-feto-protein(AFP)levels are also increased in almost allcases.Liver metastasis is observed in approximately 80% of cases and portal vein tumor thrombus is ob-served in approximately 20% of cases.Differential diagnosis between metastatic liver tumor and HCC is often difficult.Grossly,almost all cases appear as advanced gastric cancer.Histologically,a hepatoid pattern is observed in many cases,in addition to a moderately to poorly differentiated adenocarcinoma component.The production of PIVKA-Ⅱ and AFP is usually confirmed using immunohistochemical staining.Treatment and prognosis largely depends on the existence of liver meta-stasis,and the prognosis of patients with liver metas-tasis is very poor.PIVKA-Ⅱ may be produced during the hepatocellular metaplasia of the tumor cells.
文摘1前言肝细胞样癌是一种肝外器官或组织中发生的具有肝细胞样结构和形态学特征的腺癌。肝细胞样癌最初被描述为可以产生甲胎蛋白(alpha-fetoprotein,AFP)的肿瘤^([1])。最早在1985年,Ishikura等^([2])报道了具有肝细胞癌样分化的胃癌病例,患者血清及肿瘤组织中的AFP水平均明显增高,由此提出了胃肝细胞样癌的概念。1987年,Ishikura等^([3])首次报道了卵巢肝细胞样癌(hepatoid carcinoma of the ovary,HCO)的病例,至今文献报道不足50例^([4])。此外,肝细胞样癌还可发生于其他组织器官,如肠道、胰腺、胆囊、肺、膀胱、肾脏、子宫等。其中,胃是最常见的发生部位,而卵巢在生殖系统中最为常见^([5-11])。
