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Review
. 2019 Apr;98(14):e15053.
doi: 10.1097/MD.0000000000015053.

Primary pulmonary hepatoid adenocarcinoma: A case report and review of the literature

Kun Yang  1 , Huifeng Jiang  2 , Qiuyao Li  2
Affiliations
Review

Primary pulmonary hepatoid adenocarcinoma: A case report and review of the literature

Kun Yang et al. Medicine (Baltimore). 2019 Apr.

Abstract

Rationale: Hepatoid adenocarcinoma of lung (HAL) is a rare malignant tumor, which can be defined as a primary alpha-fetoprotein (AFP)-producing lung carcinoma. The majority of hepatoid adenocarcinoma (HAC) expressed AFP in tumor cells, but AFP expression is not required for its diagnosis according to the modified diagnostic criteria. Despite that HAC exhibits a poor prognosis and ineffective treatment options, early diagnosis and aggressive treatment can result in long-term survival.

Patient concerns: We report a 70-year-old Chinese male patient with alcoholic intake over 30 years and smoking history of 60 cigarettes per day for 40 years. He sought medical consultation for productive cough and hemoptysis sputum.

Diagnoses and interventions: Chest CT scan revealed a mass (6.4 × 5.5 cm) in the left lower lobe of the lung. The patient underwent curative surgical resection, and subsequently diagnosed as HAL.

Outcomes: Eighteen months after primary diagnosis, the patient died of multiple organ failure caused by distant metastases.

Lessons: Familiarizing with the clinical features and modified diagnostic criteria of this rare tumor may increase awareness of the disease among clinicians and pathologists, thereby avoiding misdiagnosis and mistreatment.

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Conflict of interest statement

All the authors do not have any possible conflicts of interest.

Figures

Figure 1
Figure 1
(A) Chest radiograph demonstrates a left lower lobe mass (arrow). (B) Chest computed tomography reveals a 6.4 cm mass (arrow) in the left lower lobe.
Figure 2
Figure 2
Left lower lobe mass (6 × 6 × 5.5 cm) appears as solid, white-grayish, firm tumor part surrounding the bronchi.
Figure 3
Figure 3
(A) Tumor cells are arranged in sheet-like or trabecular proliferation patterns, resembling HCC with focal necrosis. Hematoxylin and eosin (HE) staining, 100×. (B) Cytoplasmic bile plugs (arrow). HE staining, 200×. (C) Periodic acid-Schiff (PAS)-positive, diastase-resistant hyaline globules. PAS staining, 200×. (D–G) Immunohistochemistry reveals diffusely positive for HepPar-1, CK8, CK19, and MOC31. Immunohistochemical (IHC) staining, 100×. (H) Immunohistochemistry shows positive focal staining for AFP. IHC staining, 100×. (I) Localization of monoclonal CEA to the cytoplasm and cell membrane. IHC staining, 100×.
See this image and copyright information in PMC

References

    1. Adachi Y, Tsuchihashi J, Shiraishi N, et al. AFP-producing gastric carcinoma: multivariate analysis of prognostic factors in 270 patients. Oncology 2003;65:95–101. - PubMed
    1. Metzgeroth G, Ströbel P, Baumbusch T, et al. Hepatoid adenocarcinoma - review of the literature illustrated by a rare case originating in the peritoneal cavity. Onkologie 2010;33:263–9. - PubMed
    1. Ishikura H, Fukasawa Y, Ogasawara K, et al. An AFP-producing gastric carcinoma with features of hepatic differentiation. A case report. Cancer 1985;56:840–8. - PubMed
    1. Ishikura H, Scully RE. Hepatoid carcinoma of the ovary. A newly described tumor. Cancer 1987;60:2775–84. - PubMed
    1. Paner GP, Thompson KS, Reyes CV. Hepatoid carcinoma of the pancreas. Cancer 2000;88:1582–9. - PubMed