Wang Fenfang, Han Xiaoyuan, Wu Qihuan
Department of Medical Oncology, The Affiliated Xiangshan Hospital of Wenzhou Medial University, Xiangshan, China.
Department of Center for cancer prevention and treatment, The Affiliated Xiangshan Hospital of Wenzhou Medial University, Xiangshan, China.
AME Case Rep. 2025 May 13;9:75. doi: 10.21037/acr-24-195. eCollection 2025.
Pancreatic hepatoid carcinoma (PHC) is an extremely uncommon neoplasm of pancreas that resembles hepatocellular carcinoma (HCC). The morphological and immunohistochemical features of PHC are similar to those of HCC. The lack of specificity on clinical features of PHC makes it easy to be ignored in clinical diagnosis. And there is currently no standardized treatment for PHC.
We presented a case of PHC with specific clinical examinations and treatments. The patient reported that he suffered from a history of chronic viral hepatitis B, laboratory tests showed elevated serum alpha-fetoprotein (AFP) levels. No significant liver mass was found on imaging, the contrast-enhanced abdominal computed tomography revealed a slightly nodular low-density shadow in the head of the pancreas. The patient received neoadjuvant chemotherapy combined with programmed cell death protein 1 (PD-1) antibody and he underwent radical resection of pancreatic cancer. The post-operative histopathological examination of the resection specimen revealed a diagnosis of poorly differentiated PHC. Half a month after the surgery, this patient's serum AFP dropped to within the normal range. The patient recovered without complications, and regular reexaminations showed no signs of tumor recurrence and metastasis.
We analyzed the previous PHC-related literature to enhance the understanding of PHC and persistently improve PHC treatment strategies for clinicians.
胰腺肝样癌（PHC）是一种极为罕见的胰腺肿瘤，类似于肝细胞癌（HCC）。PHC的形态学和免疫组化特征与HCC相似。PHC临床特征缺乏特异性，使其在临床诊断中容易被忽视。目前PHC尚无标准化治疗方案。
我们报告了一例接受了特定临床检查和治疗的PHC病例。患者自述有慢性乙型病毒性肝炎病史，实验室检查显示血清甲胎蛋白（AFP）水平升高。影像学检查未发现肝脏有明显肿块，腹部增强计算机断层扫描显示胰腺头部有一个略呈结节状的低密度阴影。患者接受了新辅助化疗联合程序性细胞死亡蛋白1（PD-1）抗体治疗，并接受了胰腺癌根治性切除术。切除标本的术后组织病理学检查显示诊断为低分化PHC。术后半个月，该患者血清AFP降至正常范围内。患者康复且无并发症，定期复查未显示肿瘤复发和转移迹象。
我们分析了既往与PHC相关的文献，以增进对PHC的认识，并持续为临床医生改进PHC治疗策略。
