Rectal hepatoid carcinoma with liver metastases in a patient affected by ulcerative colitis

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 p...

Full description

Saved in:
Bibliographic Details
Published in:Hepatobiliary & pancreatic diseases international 2008-10, Vol.7 (5), p.539-543
Main Authors: Borgonovo, Giacomo, Razzetta, Francesco, Assalino, Michela, Varaldo, Emanuela, Puglisi, Maria, Ceppa, Paola
Format: Article
Language:English
Subjects:
Adenocarcinoma - etiology
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
alpha-fetoprotein
Biopsy
cancer
carcinoma
Carcinoma, Hepatocellular - secondary
Carcinoma, Hepatocellular - therapy
Chemoembolization, Therapeutic
colitis
Colitis, Ulcerative - complications
Colitis, Ulcerative - pathology
colon
Diagnostic Errors
Fatal Outcome
Hepatectomy
hepatocellular
Humans
Immunohistochemistry
Liver Neoplasms - secondary
Liver Neoplasms - therapy
Male
Neoplasm Staging
Proctocolectomy, Restorative
Rectal Neoplasms - etiology
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Tomography, X-Ray Computed
ulcerative
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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 000μg/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 andmultimodal therapeutic strategy.So far,none of the hypotheses proposed about the origin and the biology of these tumors is convincing.
ISSN:1499-3872