Hepatoid carcinoma of the pancreas

Abstract

Background: Hepatoid carcinoma of the pancreas is extremely rare. This article tries to summarize the clinical features and outcomes of pancreatic hepatoid carcinoma. Methods: Data pool for analysis includes the case we encountered with hepatoid carcinoma of the pancreas and reported cases in the literature. Results: Twenty-three cases of hepatoid carcinoma of the pancreas were recruited. The most common symptom was epigastric pain (36.4%). When the tumor locates at pancreatic head, nausea/vomiting (62.5%) is more common, followed by jaundice and epigastric pain (50.0%). For those at pancreatic body-tail, 42.9% of the patients presented no symptom. Alpha-fetoprotein (AFP) was abnormally elevated in 60% cases. Hepatoid carcinoma in the pancreas could be either pure form or mixed form with other malignancy (40.9%). Metastasis occurred in 36.4% cases at the diagnosis of this tumor, including liver metastasis in 31.8% and lymph node metastasis in 21.1%. The overall 1-year survival rate was 71.1% and 5-year 40.4%. Irresectability, hepatic and lymph node metastasis are associated with poor survival outcome. Conclusions: Elevation of serum AFP may be a clue leading to the diagnosis of pancreatic hepatoid carcinoma. This tumor could be mixed form with other malignancy. Surgical resection should be the treatment of choice whenever possible.