Hepatoid Adenocarcinoma of the Anterior Skull Base: A Case Report

ABSTRACT

We report the first case of hepatoid adenocarcinoma of the skull base, as well as the first reported case in the head and neck region. Hepatoid adenocarcinoma is a rare, aggressive, extrahepatic malignancy with a distinct morphological similarity to hepatocellular carcinoma, in the absence of primary hepatic disease. A 45-year-old man presented with sinus headaches and retro-orbital pain and was found to have a nasopharyngeal mass on endoscopy and a large, destructive sinonasal mass extending intracranially on imaging. Histo- and cytopathological features were similar to hepatocellular carcinoma, and the cells were immunoreactive for α-fetoprotein, epithelial membrane antigen, periodic acid-Schiff, cytokeratin (CK)8/18, CK19, and S100.

KEYWORDS

Hepatoid adenocarcinoma - skull base tumors - AFP - sinonasal tumors

REFERENCES

• 1 Ishikura H, Kanda M, Ito M, Nosaka K, Mizuno K. Hepatoid adenocarcinoma: a distinctive histological subtype of alpha-fetoprotein-producing lung carcinoma.  Virchows Arch A Pathol Anat Histopathol. 1990;  417 73-80
• 2 Terracciano L M, Glatz K, Mhawech P et al.. Hepatoid adenocarcinoma with liver metastasis mimicking hepatocellular carcinoma: an immunohistochemical and molecular study of eight cases.  Am J Surg Pathol. 2003;  27 1302-1312
• 3 Lu C C, De-Chuan C, Lee H S, Chu H C. Pure hepatoid adenocarcinoma of the stomach with spleen and lymph-node metastases.  Am J Surg. 2010;  199 e42-e44
• 4 Ishikura H, Fukasawa Y, Ogasawara K, Natori T, Tsukada Y, Aizawa M. An AFP-producing gastric carcinoma with features of hepatic differentiation. A case report.  Cancer. 1985;  56 840-848
• 5 Nagai E, Ueyama T, Yao T, Tsuneyoshi M. Hepatoid adenocarcinoma of the stomach. A clinicopathologic and immunohistochemical analysis.  Cancer. 1993;  72 1827-1835
• 6 Ishikura H, Scully R E. Hepatoid carcinoma of the ovary. A newly described tumor.  Cancer. 1987;  60 2775-2784
• 7 Yiğit S, Uyaroğlu M A, Kuş Z, Ekinci N, Oztekin O. Hepatoid carcinoma of the ovary: immunohistochemical finding of one case and literature review.  Int J Gynecol Cancer. 2006;  16 1439-1441
• 8 Nakashima H, Nagafuchi K, Satoh H et al.. Hepatoid adenocarcinoma of the gallbladder.  J Hepatobiliary Pancreat Surg. 2000;  7 226-230
• 9 Hayashi Y, Takanashi Y, Ohsawa H, Ishii H, Nakatani Y. Hepatoid adenocarcinoma in the lung.  Lung Cancer. 2002;  38 211-214
• 10 Hameed O, Xu H, Saddeghi S, Maluf H. Hepatoid carcinoma of the pancreas: a case report and literature review of a heterogeneous group of tumors.  Am J Surg Pathol. 2007;  31 146-152
• 11 Paner G P, Thompson K S, Reyes C V. Hepatoid carcinoma of the pancreas.  Cancer. 2000;  88 1582-1589
• 12 Burgués O, Ferrer J, Navarro S, Ramos D, Botella E, Llombart-Bosch A. Hepatoid adenocarcinoma of the urinary bladder. An unusual neoplasm.  Virchows Arch. 1999;  435 71-75
• 13 Kato K, Suzuka K, Osaki T, Itami M, Tanaka N. Primary hepatoid adenocarcinoma of the uterine cervix.  Int J Gynecol Cancer. 2007;  17 1150-1154
• 14 Gopaldas R, Kunasani R, Plymyer M R, Bloch R S. Hepatoid malignancy of unknown origin—a diagnostic conundrum: review of literature and case report of collision with adenocarcinoma.  Surg Oncol. 2005;  14 11-25
• 15 Fornasa F. Soft-tissue localization of hepatoid adenocarcinoma: first case report.  Case Rep Oncol. 2010;  3 212-217
• 16 Wu Z, Upadhyaya M, Zhu H, Qiao Z, Chen K, Miao F. Hepatoid adenocarcinoma: computed tomographic imaging findings with histopathologic correlation in 6 cases.  J Comput Assist Tomogr. 2007;  31 846-852