Primary Hepatoid Carcinoma of the Pancreas: A Clinicopathological Study of 3 Cases With Review of Additional 31 Cases in the Literature
| Autor: | Lixin Zhou, Jenny Z. Lai, Chen Yang, Li Sun, Yanfeng Xi, Elaine O. Dooley, Yu Tao, Zhen Liu, Dengfeng Cao |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Adenocarcinoma Gastroenterology Neuroendocrine differentiation Glandular Differentiation Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Carcinoembryonic antigen Internal medicine medicine Humans Lymph node Aged Aged 80 and over Univariate analysis biology business.industry Middle Aged medicine.disease digestive system diseases Pancreatic Neoplasms 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Hepatocellular carcinoma biology.protein T-stage Surgery Anatomy business Pancreas |
| Zdroj: | International Journal of Surgical Pathology. 27:28-42 |
| ISSN: | 1940-2465 1066-8969 |
| DOI: | 10.1177/1066896918783468 |
| Popis: | Primary pancreatic hepatoid carcinoma (PHC) is very rare. Here, we reported 3 such cases with review of additional 31 cases in the literature. Our 3 patients were male (83, 72, and 54 years old, respectively). Serum α-fetoprotein (AFP) was elevated in 1 patient (case 3, 8338 ng/mL) and not measured in the other two. The PHC in patient 1 (pathological stage pT2N0M0) and patient 2 (pT3N0M0) showed pure hepatocellular carcinoma (HCC)-like morphology, whereas in case 3 it was a PHC with true glandular differentiation (pT4N0M0). The diagnosis of PHC was confirmed with positive immunohistochemical staining in the tumor cells for AFP (2/3), Hep Par 1 (3/3), glypican-3 (2/3), arginase-1 (2/3), and Sal-like protein 4 (1/3). CD10 and polyclonal carcinoembryonic antigen stains show focal canalicular pattern in 2/3 tumors. Patient 1 did not receive further treatment after resection and was alive with no evidence of disease at 107 months. Patient 2 died of postoperative complications, whereas patient 3 received postsurgical chemoradiation and died of disease at 29 months. Our findings and literature review indicate that PHCs can be divided into 4 histological subtypes: with pure HCC-like morphology (n = 22), with neuroendocrine differentiation (n = 8), with true glandular differentiation (n = 3), and with acinar cell differentiation (n = 1). On univariate analysis, pure HCC-like morphology was associated with better disease-specific survival (DSS; P = .04), whereas lymph node and distant metastases were associated with worse DSS ( P = .002 for both). Age, gender, presenting symptoms, serum AFP level, and T stage were not associated with DSS. On multivariate analysis, none of these parameters was significantly associated with DSS. |
| Databáze: | OpenAIRE |
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