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Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review

Hepatoid adenocarcinoma of the duodenum is a rare special type of adenocarcinoma, featured by hepatocyte components in primary adenocarcinoma of the duodenum. It has the characteristics of high malignancy, invasiveness, rapid progress, and poor prognosis. An abnormal elevation of serum alpha-fetopro...

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Autores principales: Han, Lu, Ding, Naiqing, Li, Li, Wei, Xiao, Hu, Jing, Liu, Baorui, Qian, Xiaoping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393733/
https://www.ncbi.nlm.nih.gov/pubmed/36003790
http://dx.doi.org/10.3389/fonc.2022.948892
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author Han, Lu
Ding, Naiqing
Li, Li
Wei, Xiao
Hu, Jing
Liu, Baorui
Qian, Xiaoping
author_facet Han, Lu
Ding, Naiqing
Li, Li
Wei, Xiao
Hu, Jing
Liu, Baorui
Qian, Xiaoping
author_sort Han, Lu
collection PubMed
description Hepatoid adenocarcinoma of the duodenum is a rare special type of adenocarcinoma, featured by hepatocyte components in primary adenocarcinoma of the duodenum. It has the characteristics of high malignancy, invasiveness, rapid progress, and poor prognosis. An abnormal elevation of serum alpha-fetoprotein (AFP) may occur in most cases. The diagnosis is mainly based on pathological morphology. Here, we reported a case of hepatic adenocarcinoma of the duodenum. The middle-aged female patient had an ampulla mass at diagnosis and received radical pancreaticoduodenectomy. The postoperative pathology was stage IIIA duodenal adenocarcinoma. At 1 month after surgery, she had multiple intrahepatic metastases and retroperitoneal lymph node metastasis; the AFP level was 300 ng/ml at that time. As she refused target therapy, two cycles of capecitabine-oxaliplatin (XELOX) chemotherapy were performed. However, the AFP elevated from 300 to 1,931.90 ng/ml, and the disease progressed rapidly. Immunohistochemistry (IHC) of tissue samples from presurgical endoscopic ultrasound guided fine needle aspiration (EUS-FNA), surgery, and liver biopsy showed positive AFP staining. Combining the abnormal elevation of serum AFP and microscopic pathological morphology, this case is diagnosed as hepatoid adenocarcinoma of the duodenum with liver metastasis. The physical condition of this patient was too poor to receive follow-up treatment. She died of the rapid disease progression with an overall survival time of 161 days. Considering that in most patients with hepatoid adenocarcinoma the abnormal elevation of serum AFP occurs preoperatively and returns to normal postoperatively rather than normal before surgery and increased after surgery, the primary lesion is located in the stomach rather than the intestine, and the patients are more often older men rather than middle-aged women; this case is rare particularly. Therefore, reporting this case with complete case data may be helpful to further study, so as to improve the understanding of this special type of malignant tumor.
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spelling pubmed-93937332022-08-23 Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review Han, Lu Ding, Naiqing Li, Li Wei, Xiao Hu, Jing Liu, Baorui Qian, Xiaoping Front Oncol Oncology Hepatoid adenocarcinoma of the duodenum is a rare special type of adenocarcinoma, featured by hepatocyte components in primary adenocarcinoma of the duodenum. It has the characteristics of high malignancy, invasiveness, rapid progress, and poor prognosis. An abnormal elevation of serum alpha-fetoprotein (AFP) may occur in most cases. The diagnosis is mainly based on pathological morphology. Here, we reported a case of hepatic adenocarcinoma of the duodenum. The middle-aged female patient had an ampulla mass at diagnosis and received radical pancreaticoduodenectomy. The postoperative pathology was stage IIIA duodenal adenocarcinoma. At 1 month after surgery, she had multiple intrahepatic metastases and retroperitoneal lymph node metastasis; the AFP level was 300 ng/ml at that time. As she refused target therapy, two cycles of capecitabine-oxaliplatin (XELOX) chemotherapy were performed. However, the AFP elevated from 300 to 1,931.90 ng/ml, and the disease progressed rapidly. Immunohistochemistry (IHC) of tissue samples from presurgical endoscopic ultrasound guided fine needle aspiration (EUS-FNA), surgery, and liver biopsy showed positive AFP staining. Combining the abnormal elevation of serum AFP and microscopic pathological morphology, this case is diagnosed as hepatoid adenocarcinoma of the duodenum with liver metastasis. The physical condition of this patient was too poor to receive follow-up treatment. She died of the rapid disease progression with an overall survival time of 161 days. Considering that in most patients with hepatoid adenocarcinoma the abnormal elevation of serum AFP occurs preoperatively and returns to normal postoperatively rather than normal before surgery and increased after surgery, the primary lesion is located in the stomach rather than the intestine, and the patients are more often older men rather than middle-aged women; this case is rare particularly. Therefore, reporting this case with complete case data may be helpful to further study, so as to improve the understanding of this special type of malignant tumor. Frontiers Media S.A. 2022-08-08 /pmc/articles/PMC9393733/ /pubmed/36003790 http://dx.doi.org/10.3389/fonc.2022.948892 Text en Copyright © 2022 Han, Ding, Li, Wei, Hu, Liu and Qian https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Han, Lu
Ding, Naiqing
Li, Li
Wei, Xiao
Hu, Jing
Liu, Baorui
Qian, Xiaoping
Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review
title Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review
title_full Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review
title_fullStr Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review
title_full_unstemmed Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review
title_short Hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: A case report and literature review
title_sort hepatoid adenocarcinoma of the duodenal papilla with hepatic metastases: a case report and literature review
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393733/
https://www.ncbi.nlm.nih.gov/pubmed/36003790
http://dx.doi.org/10.3389/fonc.2022.948892
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