Yahaya A, Wa Kammal W S, Abd Shukor N, Osman S S
University Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia.
Malays J Pathol. 2019 Apr;41(1):59-63.
Alpha-fetoprotein (AFP)-producing carcinoma which microscopically mimics hepatocellular carcinoma (HCC) is a rare entity known as hepatoid adenocarcinoma (HC). They usually arise in the stomach, while oesophageal origin is only occasionally encountered. This tumour is highly aggressive and is associated with a poor prognosis. They frequently metastasise to the liver, thus giving rise to diagnostic difficulty, especially in cases where simultaneous oesophageal and liver mass are present. We reported a case of oesophageal hepatoid carcinoma with multiple liver metastasis, that was associated with an increased serum AFP. The distinction between HCC and HC is important because HC is more aggressive and has a poorer prognosis with limited therapeutic options. An extensive diagnostic work-up which include a thorough clinical history, radiological investigations (computed tomography or magnetic resonance imaging) as well as tissue biopsy supported by a panel of immunohistochemical markers are necessary to aid in the diagnosis of HC.
产生甲胎蛋白（AFP）的癌在显微镜下酷似肝细胞癌（HCC），是一种罕见的实体，称为肝样腺癌（HC）。它们通常发生于胃，而食管来源仅偶尔见到。这种肿瘤具有高度侵袭性，预后较差。它们常转移至肝脏，从而导致诊断困难，尤其是在同时存在食管和肝脏肿块的病例中。我们报告了1例伴有多发肝转移的食管肝样癌病例，该病例血清AFP升高。区分HCC和HC很重要，因为HC侵袭性更强，预后更差，且治疗选择有限。进行全面的诊断检查，包括详尽的临床病史、放射学检查（计算机断层扫描或磁共振成像）以及由一组免疫组化标志物支持的组织活检，对于辅助HC的诊断是必要的。
