Hepatoid adenocarcinoma (HAC) is a rare but important special type of extrahepatic adenocarcinoma with clinicopathological presentation mimicking hepatocellular carcinoma (HCC), and prompt and correct diagnosis can be...Hepatoid adenocarcinoma (HAC) is a rare but important special type of extrahepatic adenocarcinoma with clinicopathological presentation mimicking hepatocellular carcinoma (HCC), and prompt and correct diagnosis can be a challenge, especially in endemic areas with a high incidence of HCC. To date, HAC has only been reported in case series or single case reports, so we aimed to review the clinicopathological characteristics of HAC to obtain a more complete picture of this rare form of extrahepatic adenocarcinoma. All the articles about HAC published from 2001 to 2011 were reviewed, and clinicopathological findings were extracted for analysis. A late middle-aged male with high serum α-fetoprotein and atypical image finding of HCC should raise the suspicion of HAC, and characteristic pathological immunohistochemical stains can help with the differential diagnosis. Novel immunohistochemical markers may be useful to clearly differentiate HAC from HCC. Once metastatic HAC is diagnosed, the primary tumor origin should be identified for adequate treatment. The majority of HAC originates from the stomach, so panendoscopy should be arranged first.展开更多
Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However,its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this wo...Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However,its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this work is to report an adenocarcinoma of the third and fourth duodenal portions,emphasizing its diagnostic difficulty and the value of video capsule endoscopy. A man,40 years old,with no medical history,with abdominal discomfort and progressive fatigue,presented four months ago with one episode o f m o d e ra t e m e l e n a. T h e p hy s i c a l e x a m i n a t i o n was normal,except for mucosal pallor. Blood tests were consistent with microcytic,hypochromic iron deficiency anemia with 7.8 g/d L hemoglobin. The upper and lower endoscopy were normal. Additional work-up with video capsule endoscopy showed a polypoid lesion involving the third and fourth portions o f t h e d u o d e n u m. B i o p s y s h o w e d a m o d e ra t e l y differentiated adenocarcinoma. Abdominal computed tomography showed a wall thickening from the third duodenal portion to the proximal jejunum,without distant metastasis. The patient underwent segmental resection(distal duodenum and proximal jejunum) with duodenojejunostomy. The surgical specimen histology confirmed the biopsy diagnosis,with transmural infiltration,without nodal involvement. Conclusion: Adenocarcinoma of the third and fourth portions of the duodenum is difficult to diagnose and capsule endoscopy is of great value.展开更多
文摘Hepatoid adenocarcinoma (HAC) is a rare but important special type of extrahepatic adenocarcinoma with clinicopathological presentation mimicking hepatocellular carcinoma (HCC), and prompt and correct diagnosis can be a challenge, especially in endemic areas with a high incidence of HCC. To date, HAC has only been reported in case series or single case reports, so we aimed to review the clinicopathological characteristics of HAC to obtain a more complete picture of this rare form of extrahepatic adenocarcinoma. All the articles about HAC published from 2001 to 2011 were reviewed, and clinicopathological findings were extracted for analysis. A late middle-aged male with high serum α-fetoprotein and atypical image finding of HCC should raise the suspicion of HAC, and characteristic pathological immunohistochemical stains can help with the differential diagnosis. Novel immunohistochemical markers may be useful to clearly differentiate HAC from HCC. Once metastatic HAC is diagnosed, the primary tumor origin should be identified for adequate treatment. The majority of HAC originates from the stomach, so panendoscopy should be arranged first.
文摘Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However,its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this work is to report an adenocarcinoma of the third and fourth duodenal portions,emphasizing its diagnostic difficulty and the value of video capsule endoscopy. A man,40 years old,with no medical history,with abdominal discomfort and progressive fatigue,presented four months ago with one episode o f m o d e ra t e m e l e n a. T h e p hy s i c a l e x a m i n a t i o n was normal,except for mucosal pallor. Blood tests were consistent with microcytic,hypochromic iron deficiency anemia with 7.8 g/d L hemoglobin. The upper and lower endoscopy were normal. Additional work-up with video capsule endoscopy showed a polypoid lesion involving the third and fourth portions o f t h e d u o d e n u m. B i o p s y s h o w e d a m o d e ra t e l y differentiated adenocarcinoma. Abdominal computed tomography showed a wall thickening from the third duodenal portion to the proximal jejunum,without distant metastasis. The patient underwent segmental resection(distal duodenum and proximal jejunum) with duodenojejunostomy. The surgical specimen histology confirmed the biopsy diagnosis,with transmural infiltration,without nodal involvement. Conclusion: Adenocarcinoma of the third and fourth portions of the duodenum is difficult to diagnose and capsule endoscopy is of great value.
