Open Access

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

  • Authors:
    • Andreea Iliesiu
    • Radu-Valeriu Toma
    • Ana Maria Ciongariu
    • Radu Costea
    • Narcis Zarnescu
    • Liviu Bîlteanu
  • View Affiliations

  • Published online on: August 28, 2023     https://doi.org/10.3892/ol.2023.14029
  • Article Number: 442
  • Copyright: © Iliesiu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

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.
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October-2023
Volume 26 Issue 4

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Iliesiu A, Toma R, Ciongariu AM, Costea R, Zarnescu N and Bîlteanu L: A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review. Oncol Lett 26: 442, 2023
APA
Iliesiu, A., Toma, R., Ciongariu, A.M., Costea, R., Zarnescu, N., & Bîlteanu, L. (2023). A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review. Oncology Letters, 26, 442. https://doi.org/10.3892/ol.2023.14029
MLA
Iliesiu, A., Toma, R., Ciongariu, A. M., Costea, R., Zarnescu, N., Bîlteanu, L."A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review". Oncology Letters 26.4 (2023): 442.
Chicago
Iliesiu, A., Toma, R., Ciongariu, A. M., Costea, R., Zarnescu, N., Bîlteanu, L."A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review". Oncology Letters 26, no. 4 (2023): 442. https://doi.org/10.3892/ol.2023.14029