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Rectal hepatoid carcinoma with liver metastases in a patient affected by ulcerative colitis.
Hepatobiliary Pancreat Dis Int. 2008 Oct; 7(5):539-43.HP

Abstract

BACKGROUND

Hepatoid tumors (HTs) are rare extra-hepatic neoplasms with the histological features, biochemical profile and, sometimes, even clinical course of hepatocellular carcinoma. We present a case of rectal hepatoid adenocarcinoma with metachronous liver metastases.

METHODS

Four months after total procto-colectomy for a rectal adenocarcinoma (Astler-Coller C2), a 42-year-old man with ulcerative colitis showed hypoechoic masses in the hepatic parenchyma by abdominal ultrasonography. Carcinoembryonic antigen was normal, but alpha-fetoprotein was 32,000 microg/L. Fine-needle biopsy revealed that liver masses were positive for hepatocellular carcinoma. The patient underwent left hepatectomy and alcoholisation of a small deep nodule in segment 8.

RESULTS

Immunohistochemistry and albumin mRNA in situ hybridization suggested that the nodules were metastases of a HT. The patient was well during the first 6 months and refused any adjuvant chemotherapy. He died from liver failure 19 months after initial diagnosis.

CONCLUSIONS

HT is a rare colon cancer. The preoperative diagnosis of this tumor requires a high degree of suspicion, the availability of a panel of immunohistochemical markers, and a certain amount of luck. The prognosis is poor despite an aggressive and multimodal therapeutic strategy. So far, none of the hypotheses proposed about the origin and the biology of these tumors is convincing.

Authors+Show Affiliations

Dipartimento di Discipline Chirurgiche, Universita degli Studi di Genova. Largo Benzi, 8. 16132 Genova, Italy. borgonovo@unige.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

18842504

Citation

Borgonovo, Giacomo, et al. "Rectal Hepatoid Carcinoma With Liver Metastases in a Patient Affected By Ulcerative Colitis." Hepatobiliary & Pancreatic Diseases International : HBPD INT, vol. 7, no. 5, 2008, pp. 539-43.
Borgonovo G, Razzetta F, Assalino M, et al. Rectal hepatoid carcinoma with liver metastases in a patient affected by ulcerative colitis. HBPD INT. 2008;7(5):539-43.
Borgonovo, G., Razzetta, F., Assalino, M., Varaldo, E., Puglisi, M., & Ceppa, P. (2008). Rectal hepatoid carcinoma with liver metastases in a patient affected by ulcerative colitis. Hepatobiliary & Pancreatic Diseases International : HBPD INT, 7(5), 539-43.
Borgonovo G, et al. Rectal Hepatoid Carcinoma With Liver Metastases in a Patient Affected By Ulcerative Colitis. HBPD INT. 2008;7(5):539-43. PubMed PMID: 18842504.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rectal hepatoid carcinoma with liver metastases in a patient affected by ulcerative colitis. AU - Borgonovo,Giacomo, AU - Razzetta,Francesco, AU - Assalino,Michela, AU - Varaldo,Emanuela, AU - Puglisi,Maria, AU - Ceppa,Paola, PY - 2008/10/10/pubmed PY - 2009/1/16/medline PY - 2008/10/10/entrez SP - 539 EP - 43 JF - Hepatobiliary & pancreatic diseases international : HBPD INT JO - HBPD INT VL - 7 IS - 5 N2 - BACKGROUND: Hepatoid tumors (HTs) are rare extra-hepatic neoplasms with the histological features, biochemical profile and, sometimes, even clinical course of hepatocellular carcinoma. We present a case of rectal hepatoid adenocarcinoma with metachronous liver metastases. METHODS: Four months after total procto-colectomy for a rectal adenocarcinoma (Astler-Coller C2), a 42-year-old man with ulcerative colitis showed hypoechoic masses in the hepatic parenchyma by abdominal ultrasonography. Carcinoembryonic antigen was normal, but alpha-fetoprotein was 32,000 microg/L. Fine-needle biopsy revealed that liver masses were positive for hepatocellular carcinoma. The patient underwent left hepatectomy and alcoholisation of a small deep nodule in segment 8. RESULTS: Immunohistochemistry and albumin mRNA in situ hybridization suggested that the nodules were metastases of a HT. The patient was well during the first 6 months and refused any adjuvant chemotherapy. He died from liver failure 19 months after initial diagnosis. CONCLUSIONS: HT is a rare colon cancer. The preoperative diagnosis of this tumor requires a high degree of suspicion, the availability of a panel of immunohistochemical markers, and a certain amount of luck. The prognosis is poor despite an aggressive and multimodal therapeutic strategy. So far, none of the hypotheses proposed about the origin and the biology of these tumors is convincing. SN - 1499-3872 UR - https://www.unboundmedicine.com/medline/citation/18842504/Rectal_hepatoid_carcinoma_with_liver_metastases_in_a_patient_affected_by_ulcerative_colitis_ L2 - http://www.diseaseinfosearch.org/result/7285 DB - PRIME DP - Unbound Medicine ER -