Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2020; 8(6): 1116-1128
Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1116
Hepatoid carcinoma of the pancreas: A case report and review of the literature
Shao-Xiong Zeng, Si-Wei Tan, Christ-Jonathan Tsia Hin Fong, Qiong Liang, Bin-Liang Zhao, Ke Liu, Jia-Xiang Guo, Jin Tao
Shao-Xiong Zeng, Si-Wei Tan, Christ-Jonathan Tsia Hin Fong, Ke Liu, Jia-Xiang Guo, Jin Tao, Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Qiong Liang, Department of Pathology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Bin-Liang Zhao, Department of Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Zeng SX and Tao J were the patient’s gastroenterologists; Liang Q performed the pathological diagnosis and contributed to manuscript drafting; Zhao BL performed the radiological diagnosis and contributed to manuscript drafting; Zeng SX, Tan SW, Fong CJTH, Liu K and Guo JX reviewed the literature and contributed to manuscript drafting; Zeng SX, Tan SW, Fong CJTH and Tao J were responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Supported by the National Natural Science Foundation for Young Scientists of China, No. 81800458; the Science and Technology Planning Project of Guangdong Province, No. 2016A020216014; and the Basic Research Program of Young Teachers’ Training Project of Sun Yat-Sen University, No. 17ykpy52.
Informed consent statement: The patient and his legal guardian provided informed written consent during the treatment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jin Tao, MD, PhD, Associate Professor, Doctor, Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China. taojin3@mail.sysu.edu.cn
Received: December 21, 2019
Peer-review started: December 21, 2019
First decision: January 12, 2020
Revised: February 16, 2020
Accepted: February 28, 2020
Article in press: February 28, 2020
Published online: March 26, 2020
Processing time: 95 Days and 21.3 Hours
Abstract
BACKGROUND

Hepatoid carcinoma (HC) is an extremely rare neoplasm that is morphologically similar to hepatocellular carcinoma. HC has been described in various organs; however, HC of the pancreas is extremely rare. To our knowledge, only 38 cases have been reported. We present a case of HC of the pancreas in a 36-year-old male patient.

CASE SUMMARY

A 36-year-old cachexic man with no significant past medical history was transferred to our hospital with a history of painless jaundice, elevated blood glucose and significant weight loss. Lab tests showed elevated serum transaminases, bilirubin and alpha-fetoprotein levels. Magnetic resonance imaging of the upper abdomen showed a diffusely enlarged pancreas, appearing “sausage-shaped”. Magnetic resonance cholangiopancreatography showed upstream ductal dilation secondary to stricture of the main pancreatic duct and the common bile duct, which were not visible. Immunohistochemistry of biopsied tissue from a percutaneous pancreatic biopsy showed tumor cell positivity for HepPar1, polyclonal carcinoembryonic antigen and CK19, suggestive of HC of the pancreas. The characteristics of 39 patients with HC of the pancreas were reviewed.

CONCLUSION

HC of the pancreas is more prevalent in males, and patients have a median age of 57 years. It is most commonly asymptomatic or presents as abdominal back pain, and the pancreatic tail is the most common location. At the time of diagnosis, liver metastasis is often present.

Keywords: Hepatoid carcinoma; Pancreas; Case report; Review

Core tip: Hepatoid carcinoma (HC) of the pancreas is an uncommon tumor with unknown characteristics. To date, there is a lack of definitive criteria for identification, and no defined treatment strategy for patients with HC of the pancreas. This study reviews 39 cases with an emphasis on diagnostic criteria and outcome management. The possibility of HC of the pancreas should be considered for diffuse lesions throughout the pancreas.