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Hepatoid carcinoma of the pancreas penetrating into the gastric cavity: A case report and literature review
Author(s) -
Kai Keita,
Nakamura Jun,
Ide Takao,
Masuda Masanori,
Kitahara Kenji,
Miyoshi Atsushi,
Noshiro Hirokazu,
Tokunaga Osamu
Publication year - 2012
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2012.02814.x
Subject(s) - pathology , pancreas , carcinoembryonic antigen , cytokeratin , vimentin , hepatocellular carcinoma , medicine , immunohistochemistry , carcinoma , abdominal cavity , cancer , anatomy
A 79‐year‐old Japanese woman was admitted to our hospital for treatment of a pancreatic tumor measuring approximately 7 × 5 cm. The tumor had invaded the left adrenal gland and gastric wall and had penetrated into the gastric cavity. Surgical resection was performed. The tumor was composed of a brown to whitish solid area and a zone of hemorrhage, necrosis, and cystic degeneration resembling the gross features of solid pseudopapillary tumor (SPT). Histologically, the tumor showed a heterogeneous growth pattern with a combination of seat‐like, trabecular, papillary and hemorrhagic‐necrotic areas in various proportions. The differential diagnoses first considered were acinar cell carcinoma, neuroendocrine carcinoma and SPT with malignant transformation. Immunohistochemistry showed tumor cells were negative for pancreatic exocrine enzymes and endocrine markers. Tumor cells diffusely expressed cytokeratin 19, alpha‐fetoprotein, carcinoembryonic antigen and glypican‐3, but lacked vimentin or β‐catenin expression. Small proportions of tumor cells expressed hepatocyte paraffin‐1. Although typical morphological features of well‐differentiated hepatocellular carcinoma (HCC) were not distinctly apparent, the tumor morphology partly resembled poorly differentiated HCC. Given these findings and considerations, the tumor was finally diagnosed as poorly differentiated hepatoid carcinoma of the pancreas.