A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review.

Autor: Iliesiu A; Department of Pathology, University Emergency Hospital of Bucharest, Bucharest 014461, Romania.; Faculty of General Medicine, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania., Toma RV; Faculty of General Medicine, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania.; Oncological Institute 'Alexandru Trestioreanu', Bucharest 022328, Romania., Ciongariu AM; Department of Pathology, University Emergency Hospital of Bucharest, Bucharest 014461, Romania.; Faculty of General Medicine, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania., Costea R; Faculty of General Medicine, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania.; Second Department of Surgery, University Emergency Hospital of Bucharest, Bucharest 050098, Romania., Zarnescu N; Faculty of General Medicine, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania.; Second Department of Surgery, University Emergency Hospital of Bucharest, Bucharest 050098, Romania., Bîlteanu L; Oncological Institute 'Alexandru Trestioreanu', Bucharest 022328, Romania.; Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine, Bucharest 050097, Romania.
Jazyk: angličtina
Zdroj: Oncology letters [Oncol Lett] 2023 Aug 28; Vol. 26 (4), pp. 442. Date of Electronic Publication: 2023 Aug 28 (Print Publication: 2023).
DOI: 10.3892/ol.2023.14029
Abstrakt: In rare cases, metastatic adenocarcinomas of different origin may exhibit the features of hepatoid carcinoma (HC), a rare malignant epithelial tumor, most commonly occurring in the ovaries and stomach, as well as in the pancreas and biliary ducts. A case of a 72-year-old female patient who developed a highly aggressive, poorly differentiated pancreatic ductal adenocarcinoma with peritoneal carcinomatosis, demonstrating hepatoid differentiation upon conventional hematoxylin and eosin staining is reported in the present study. The patient presented with severe abdominal pain, and the radiological investigations performed revealed ovarian and hepatic tumor masses and peritoneal lesions, which were surgically removed. The gross examination of the peritoneum and omentum revealed multiple solid, firm, grey-white nodules, diffusely infiltrating the adipose tissue. The microscopic examination revealed a malignant epithelial proliferation, composed of polygonal cells with abundant eosinophilic cytoplasm and irregular, pleomorphic nuclei. Certain cells presented with intracytoplasmic mucus inclusions, raising suspicion of a HC with an uncertain histogenesis. Immunohistochemical staining was performed, and the tumor cells were found to be positive for cytokeratin (CK)7, CK18 and mucin 5AC, whereas negative staining for CK20, caudal-type homeobox transcription factor 2, α-fetoprotein, paired box gene 8, GATA-binding protein 3 and Wilms tumor 1 were documented. Thus, the diagnosis of metastatic pancreatic adenocarcinoma was established. The main aim of the present study was to provide further knowledge concerning poorly differentiated metastatic adenocarcinoma resembling HC, emphasizing the histopathological and immunohistochemical features of these malignant lesions and raising awareness of the diagnostic difficulties that may arise, as well as the importance of the use immunohistochemistry in differentiating carcinomas of uncertain histogenesis.
Competing Interests: The authors declare that they have no competing interests.
(Copyright: © Iliesiu et al.)
Databáze: MEDLINE
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