Abstract
Hepatoid carcinoma of the ovary (HCO), a rare invasive malignant tumor composed mainly of epithelioid cells, presented with unilateral or bilateral ovarian masses and elevated serum α-fetoprotein (AFP), has been found mainly in post-menopausal women. We hereby report on the case of a 53-year-old Chinese woman who presented with abdominal distension and a lower abdominal mass with high serum levels of CA-125 and AFP. She was later diagnosed with bilateral HCO. After surgery and following chemotherapy, the patient had no recurrence of tumor or ascites. The hepatoid cells were positive for AFP, p53 and CK7 by immunohistochemistry. Her serum CA-125 and AFP levels had decreased significantly after surgery. Our results suggest that testing and monitoring of serum levels of AFP and CA-125 are considered as potential biomarkers in the diagnosis and progression of this malignancy, and that tissue immunohistochemical staining for AFP, p53 and CK7, plays an important role in distinguishing HCO from other ovarian tumors.
Highlights
Hepatoid carcinomas are less frequently occurring tumors of the stomach, lungs, kidneys, endometrium and ovaries, with pathological features similar to those of hepatocellular carcinoma (HCC)
The results showed that hepatoid cells were positive for AFP, p53 and CK7 and focally positive for α-inhibin, but negative for CK20, CDX-2, Vimentin, CA-125, OCT3/4, NSE, hepatocyte paraffin 1, WT1, PLAP, AG/AG, polyclonal carcinoembryonic antigen (CEA), EMA, CD10 and CgA (Figure 3)
Hepatoid carcinoma of the ovary (HCO) resembles HCC, which are composed of solid sheets or aggregates of uniform cells with moderate and abundant acidophilic cytoplasm, distinct cell borders and centrally located, prominent nuclei
Summary
Hepatoid carcinomas are less frequently occurring tumors of the stomach, lungs, kidneys, endometrium and ovaries, with pathological features similar to those of hepatocellular carcinoma (HCC). Hepatoid carcinoma of the ovary (HCO) is a very rare type of high-grade, invasive malignant ovarian tumor composed mainly of epithelioid cells This malignancy has been reported mainly in post-menopausal women presenting with unilateral or bilateral ovarian masses and elevated serum level of α-fetoprotein (AFP). These tumors are characterized by solid sheets of large cells with abundant eosinophilic cytoplasm, centrally pleomorphic nuclei and distinct cellular borders. Follow-up examination with color Doppler ultrasound of the abdomen and pelvic cavity 15 months after treatment showed no recurrence of tumor and ascites Her serum CA-125 and AFP levels decreased to 10.87 U/mL and 113.30 ng/mL, respectively
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