α-Fetoprotein-producing adenocarcinoma of the pancreas presenting focal hepatoid differentiation

• Published in: International journal of gastrointestinal cancer 1999-08, Vol.26 (1), p.43-47
• Main Authors: TANNO, S, OBARA, T, FUJII, T, IZAWA, T, MIZUKAMI, Y, SAITOH, Y, URA, H, KOHGO, Y
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - metabolism; Aged; alpha-Fetoproteins - biosynthesis; Biological and medical sciences; Carcinoma, Hepatocellular - metabolism; Cell Differentiation - physiology; Digestive system; Female; Humans; Immunohistochemistry; Investigative techniques, diagnostic techniques (general aspects); Lymphatic Metastasis; Medical sciences; Pancreatic Neoplasms - metabolism; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
• ISSN: 0169-4197; 1537-3649; 1537-3649
• DOI: 10.1385/ijgc:26:1:43

We report a rare case of pancreatic carcinoma producing alpha-fetoprotein (AFP), showing focal hepatoid differentiation in metastatic lymph nodes. A 65-yr-old female was admitted because of abdominal pain. The serum AFP was measured at 16,170 ng/mL. Radiological examinations revealed a mass measuring 6 cm in diameter in the body and tail of the pancreas. A right supraclavicular lymphadenopathy was found and biopsied. Light microscopy showed a tumor consisting of a portion of a hepatoid area and well-differentiated adenocarcinoma, which was suggestive of a hepatoid adenocarcinoma. Immunohistochemical analysis showed that the tumor cells expressed AFP, alpha 1-antitrypsin (AT) and albumin. Although the pathological diagnosis of the primary pancreatic tumor was not obtained, this appears to be the first case of hepatoid adenocarcinoma of the pancreas.