Hepatoid adenocarcinoma of the lung without production of α-fetoprotein: A case report and review of the literature

Abstract

Hepatoid adenocarcinoma of the lung (HAL) is a rare type of extrahepatic hepatoid adenocarcinoma. The majority of such cases that have been reported in the English literature have demonstrated elevated serum α-fetoprotein (AFP) and/or positive AFP expression on histopathological analysis, and have had poor prognoses. The current study reports an extremely rare case of HAL in the right upper lung without AFP production in a 59-year-old male patient. The patient underwent radical right upper lobectomy via video assisted thoracoscopic surgery. No signs of local recurrence or distant metastasis have been observed for 23 months after the surgery. The serum AFP level following surgery remained within the normal range. Although the diagnosis of HAL predominantly depends on pathological examination, a review of the literature demonstrates that HAL has certain characteristic features with regard to its clinical and computed tomography findings and prognoses, and clinicians should be aware that clinicians should be aware that monitoring serum AFP levels, as well as CT findings, remains important.

Keywords: computed tomography; hepatoid adenocarcinoma; lung; α-fetoprotein.

Figure 1.

Chest CT images from a 59-year-old male patient. (A) CT image of the lung window revealed a well-defined mass in the right upper lung. (B) Non-contrast axial CT image of the mediastinal window revealed a well-defined mass invading the costal pleura. (C) Contrast-enhanced CT image in the arterial phase revealed inhomogenous mild enhancement in the majority of the tumor. (D) Contrast-enhanced CT image in the delay phase revealed moderate to significant peripheral and patchy enhancement. (E,F) Contrast-enhanced sagittal and coronal plane CT images tumor. CT, computed tomography.

Figure 2.

Histological findings. (A) The cells were arranged in trabecular and solid mass-like growth patterns (hematoxylin and eosin staining; magnification, ×10). (B) Immunohistochemical staining revealing positivity for hepatocyte paraffin 1.