Abstract
Hepatoid adenocarcinoma is a rare variant of extrahepatic adenocarcinoma which behaves like hepatocellular carcinoma in morphology and functionality.We present a rare case of hepatoid adenocarcinoma of the gallbladder which invades deeply the liver bed, in a 59-year-old woman. Histologically, most of the mass in the gallbladder was composed of cells with eosinophilic cytoplasm arranged in a trabecular pattern, which resembled hepatocellular carcinoma. The main differential diagnosis was hepatocellular carcinoma with invasion into the gallbladder. The gallbladder origin of the hepatoid adenocarcinoma was verified by the presence of foci of conventional adenocarcinoma, the recognition of high-grade dysplasia in the adjacent epithelium and the absence of cirrhosis.
Highlights
Hepatoid adenocarcinoma (HAC) is a variety of adenocarcinoma associated with hepatic differentiation
Ultrasonography and computed tomography revealed a solid mass within the gallbladder, which infiltrates the adjacent liver without signs of cirrhosis (Figure 1a, b)
Hepatoid adenocarcinoma (HAC) is a rare variety of extrahepatic adenocarcinoma, consisting of foci of both adenomatous and hepatocellular differentiations which behave like hepatocellular carcinoma (HCC) in morphology and functionality [1]
Summary
Hepatoid adenocarcinoma (HAC) is a variety of adenocarcinoma associated with hepatic differentiation. A few cases of HAC of the gallbladder have been reported [1]. Ultrasonography and computed tomography revealed a solid mass within the gallbladder, which infiltrates the adjacent liver without signs of cirrhosis (Figure 1a, b). Gross examination revealed a white and yellow solid tumor, measuring 11 × 5 cm, occupying the body of the gallbladder and invading the liver bed. Bile plugs were recognized intracellularly and foci of high-grade dysplasia were observed in the gallbladder epithelium adjacent to the tumor (Figure 2). The carcinoma with hepatoid features was diffusely stained for a fetoprotein (AFP), HepPar-1 (Figure 3a) and Hepatocyte-cell antibodies, but not for Keratin, whereas the well-differentiated adenocarcinoma was immunoreactive for Keratin but not for AFP or Hepatocyte-cell. The patient is still alive without any further therapeutic intervention
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