Hepatocellular carcinoma containing endocrine cells. An autopsy report of triplecancer involving the liver, kidney and thyroid

Abstract

An autopsy case of triplecancer (hepatocellular carcinoma of the liver, renal cell carcinoma of the kidney, and papillary carcinoma of the thyroid) was reported. Histological features of primary hepatic tumor suggested undifferentiated hepatocellular carcinoma (Edmondson-Steiner's Grade IV). However, certain tumor cells showed distinctive argyrophilic reactions and electron microscopy revealed small round granules resembling electron dense endocrine secretory granules in their cytoplasm. Immunohistochemistry demonstrated that tumor cells showed a positive reaction for AFP while some others were positive for chromogranin-A. Immunohistochemical demonstration of AFP production by tumor cells indicated their hepatocyte origin. No endocrine syndrome had been present and no alternative primary source of the endocrine tumor was detected. Tumors of the kidney and thyroid were considered to be incidentally combined.