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Hepatoid Carcinoma of the Pancreas: Case Report, Next-Generation Tumor Profiling, and Literature Review

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ABSTRACT

Fewer than 25 cases of hepatoid carcinoma of the pancreas have been reported in the literature. We present a case in a 61-year-old male with a remote history of Hodgkin's lymphoma and gastric neuroendocrine cell hyperplasia. On surveillance endoscopic ultrasound, an 8 × 5 mm cystic lesion was seen in the tail of the pancreas. MRI showed a focal pancreatic duct cut-off with mild ductal dilation. Fine needle aspiration was performed, which was concerning for acinar cell carcinoma. The patient underwent distal pancreatectomy and recovered uneventfully. Final pathology demonstrated a 1.3-cm hepatoid carcinoma of the pancreas, with a final clinicopathological stage of T1N0M0. Next-generation nucleic acid sequencing of the tumor did not suggest a viable adjuvant chemotherapeutic agent, and no adjuvant therapy was administered. The patient has no evidence of disease 6 months following resection. A further characterization and description of the outcomes of these rare tumors is warranted to help guide providers and counsel patients.

No MeSH data available.


Related in: MedlinePlus

Hepatoid carcinoma of the pancreas. Ki-67 immunostaining showed a proliferation index of 5–10%.
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Figure 2: Hepatoid carcinoma of the pancreas. Ki-67 immunostaining showed a proliferation index of 5–10%.

Mentions: MRI of the abdomen showed a focal duct cut-off near the junction of the pancreatic body and tail with associated mild pancreatic ductal dilatation. Fine needle aspiration of the lesion obtained via EUS revealed cellular smears with variably sized groups of cells with round nuclei and abundant cytoplasm (fig 1). Immunohistochemistry showed the tumor cells had membrane reactivity for β-catenin but no nuclear reactivity. Chromogranin and synaptophysin were nonreactive. Ki-67 immunostaining showed a proliferation index of 5–10% (fig 2). A diagnosis of acinar cell carcinoma of the pancreas was favored based on these findings.


Hepatoid Carcinoma of the Pancreas: Case Report, Next-Generation Tumor Profiling, and Literature Review
Hepatoid carcinoma of the pancreas. Ki-67 immunostaining showed a proliferation index of 5–10%.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121547&req=5

Figure 2: Hepatoid carcinoma of the pancreas. Ki-67 immunostaining showed a proliferation index of 5–10%.
Mentions: MRI of the abdomen showed a focal duct cut-off near the junction of the pancreatic body and tail with associated mild pancreatic ductal dilatation. Fine needle aspiration of the lesion obtained via EUS revealed cellular smears with variably sized groups of cells with round nuclei and abundant cytoplasm (fig 1). Immunohistochemistry showed the tumor cells had membrane reactivity for β-catenin but no nuclear reactivity. Chromogranin and synaptophysin were nonreactive. Ki-67 immunostaining showed a proliferation index of 5–10% (fig 2). A diagnosis of acinar cell carcinoma of the pancreas was favored based on these findings.

View Article: PubMed Central - PubMed

ABSTRACT

Fewer than 25 cases of hepatoid carcinoma of the pancreas have been reported in the literature. We present a case in a 61-year-old male with a remote history of Hodgkin's lymphoma and gastric neuroendocrine cell hyperplasia. On surveillance endoscopic ultrasound, an 8 × 5 mm cystic lesion was seen in the tail of the pancreas. MRI showed a focal pancreatic duct cut-off with mild ductal dilation. Fine needle aspiration was performed, which was concerning for acinar cell carcinoma. The patient underwent distal pancreatectomy and recovered uneventfully. Final pathology demonstrated a 1.3-cm hepatoid carcinoma of the pancreas, with a final clinicopathological stage of T1N0M0. Next-generation nucleic acid sequencing of the tumor did not suggest a viable adjuvant chemotherapeutic agent, and no adjuvant therapy was administered. The patient has no evidence of disease 6 months following resection. A further characterization and description of the outcomes of these rare tumors is warranted to help guide providers and counsel patients.

No MeSH data available.


Related in: MedlinePlus