Department of Pathology, Keck Medical Center, University of Southern California, Los Angeles, CA, USA.
Department of Radiology, Keck Medical Center, University of Southern California, Los Angeles, CA, USA.
Virchows Arch. 2021 Mar;478(3):605-610. doi: 10.1007/s00428-020-02864-y. Epub 2020 Jun 12.
Primary hepatic carcinoma with inhibin positivity is a rare aggressive liver tumor with seven cases described. The tumor presents at a younger age than primary hepatic carcinoma with all cases being females. RNA albumin ISH positivity suggests the tumor to be a primary hepatic carcinoma. The tumor is different from hepatocellular carcinoma as well as intrahepatic cholangiocarcinoma because of its distinct morphology, lack of hepatocellular differentiation, strong inhibin staining, and lack of typical mutations. A 26-year-old male presented with a 20-cm liver mass. The tumor progressed on therapy with development of multiple lung metastasis. Currently, the patient is enrolled in phase II clinical trial utilizing nivolumab and ipilumumab. While the tumor has a female preponderance, it is not exclusively found in females. Additional studies are necessary to determine the cause of inhibin staining, driving molecular alterations, natural history of this rare tumor, and to come up with consensus nomenclature.
具有抑制素阳性的原发性肝癌是一种罕见的侵袭性肝肿瘤,已有 7 例报道。该肿瘤的发病年龄比所有病例均为女性的具有抑制素阳性的原发性肝癌年轻。RNA 白蛋白 ISH 阳性提示肿瘤为原发性肝癌。该肿瘤与肝细胞癌和肝内胆管癌不同,因为其具有独特的形态学、缺乏肝细胞分化、强烈的抑制素染色和缺乏典型的突变。一名 26 岁男性因 20cm 肝肿块就诊。肿瘤在治疗过程中进展,出现多个肺转移。目前,该患者正在参加使用纳武单抗和伊匹单抗的 II 期临床试验。虽然该肿瘤女性居多,但并非仅见于女性。需要进一步研究以确定抑制素染色的原因、驱动分子改变、这种罕见肿瘤的自然史,并制定共识命名法。