Hepatoid adenocarcinoma of fallopian tube: A case report and review of the literature

Abstract

Rationale: Hepatoid adenocarcinoma (HAC) of the fallopian tubes is a rare malignant tumor in the female reproductive system.

Patient concerns: An 81-year-old Chinese woman presented with an elevated serum alpha-fetoprotein (AFP) level.

Diagnosis: Positron emission tomography-computed tomography (PET-CT) scan revealed a mass of approximately 47 × 27 mm located in the right adnexa. The tumor was diagnosed as a HAC arising from fallopian tube by immunohistochemical and histochemical technique.

Interventions: This patient underwent surgical treatment including a bilateral adnexectomy and appendectomy. In addition, the patient underwent 5 cycles of postoperative chemotherapy.

Outcomes: The disease has recurred approximately six months after surgery and therefore, this patient will continue to be observed.

Lessons: Up to this point, only 4 known cases of HAC originating in fallopian tube have been published in the English literature. Further studies are needed to better understand the clinical characteristics, the prognosis, and the pathological mechanism of HAC development in the fallopian tubes.

Figure 1

The Positron emission tomography-computed tomography (PET-CT) scan of upper abdomen found a mass about 47 × 27 mm located in the right adnexa (A); PET-CT scan demonstrated FDG normal uptake by the liver(B); PET-CT scan demonstrated 18F-FDG remarkable uptake by the mass(C). PET-CT = positron emission tomography- computed tomography.

Figure 2

Hematoxylin-eosinstain stain and immunohistochemistry of the fallopian tube tumor. The tumor cells arranged in the tubular, sinusoidal and nest bulk cords (A, hematoxylin-eosinstain stain ×200); The tumor was composed of round to polygonal poorly differentiated cells (B, hematoxylin-eosinstain stain ×400); The tumor cells were positive for AFP (C, immunostaining ×200); The tumor cells were positive for EMA (D, immunostaining ×200); The tumor cells were positive for Gly-3 (E, immunostaining ×200); The tumor cells were positive for SALL-4(F, immunostaining ×200). AFP = alpha-fetoprotein, SALL4 = Sal-like protein 4.

Figure 3

The change of serum APF in the therapeutic procedure. BEV = bevacizumab, CBP = carboplatin, CTX = cyclophosphamide, KSM = kengshemycinl, OXA = oxaliplatin, PTX = paclitaxel, VCR = vincristine.