Table of Contents
Definition / general | Epidemiology | Sites | Clinical features | Laboratory | Radiology description | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Molecular / cytogenetics description | Differential diagnosisCite this page: Gupta N. Hepatoid carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorhepatoid.html. Accessed August 7th, 2020.
Definition / general
- Carcinoma with hepatoid differentiation, initially described in 1987 by Isikura and Scully (Cancer 1987;60:2775)
- Appears to derive from ovarian surface epithelium
- Called "hepatoid" based on two criteria:
- Tumor cells with abundant eosinophilic cytoplasm that resembles hepatocellular carcinoma and
- Positive staining for AFP
Epidemiology
- Age range 42 to 78 years, with a mean age at diagnosis of 62 years (Acta Obstet Gynecol Scand 2007;86:498)
Sites
Clinical features
- Presents as adnexal mass, often with progressive abdominal distension and lower abdominal pain
- Highly aggressive, progresses rapidly with metastases in abdomen and occasionally to lungs, with a median survival of 2 years (Acta Obstet Gynecol Scand 2007;86:498)
Laboratory
- High serum AFP and serum CA125
Radiology description
- Solid-cystic unilateral or bilateral adnexal mass
Case reports
- 53 and 57 year old women (World J Surg Oncol 2013;11:29, Eur J Gynaecol Oncol 2004;25:745)
Treatment
- Insufficient data regarding the optimal treatment, but surgery with ovarian-like cancer chemotherapy regimens, such as carboplatin and paclitaxel, is often used (Acta Obstet Gynecol Scand 2007;86:498)
Clinical images
Images hosted on other servers:
Two soft tissue masses
Right adnexal mass (fig 1)
Gross description
- Entirely solid or with cystic areas, up to 20 cm (World J Surg Oncol 2013;11:29)
- May have multiple foci of hemorrhage and necrosis
Microscopic (histologic) description
- Resembles hepatocellular carcinoma, with tumor cells arranged in sheets, nests or trabeculae
- Cells have distinct borders, moderate to abundant eosinophilic cytoplasm, cytoplasmic PAS+ hyaline globules
Microscopic (histologic) images
AFIP images
Abundant eosinophilic cytoplasm
Hepatoid component (left)
AFP+
Images hosted on other servers:
Sheets, nests and trabeculae
Sinusoidal arrangement of vascular channels (fig 2)
AFP+ (fig 4)
AFP, p53, CK7, α inhibin
HepPar1+ (fig 3)
Molecular / cytogenetics description
- Albumin mRNA by in situ hybridization
Differential diagnosis
- Clear cell carcinoma: AFP-
- Endometrioid carcinoma: AFP-
- Hepatoid yolk sac tumor: CD10-, HepPar1-
- Metastatic hepatocellular carcinoma: presence of bile in neoplastic cells; normal CA125
- Steroid cell (lipid tumors): AFP-
