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Annals of Clinical & Laboratory Science 36:216-221 (2006)
© 2006 Association of Clinical Scientists

Case Report

A Unique Pancreatic Tumor with Exclusive Hepatocytic Differentiation

Natalie NC Shih1, Jeffrey SH Tsung1, An-Hang Yang2, Mei-Hua Tsou1 and Tsung-Yen Cheng3
1 Department of Pathology and Laboratory Medicine, 3 Department of Surgery, Koo Foundation, Sun Yat-Sen Cancer Center, Taipei, and 2 Department of Pathology, Veteran General Hospital, Taipei, Taiwan.

Address correspondence to Jeffrey SH Tsung, M.D., Sun Yat-Sen Cancer Center, No. 125, Lie-Der Road, Peitou District, Taipei, Taiwan, R.O.C; tel 886 2 2897 0011 ext 1408; fax 886 2 2897 4156; e-mail: tsung{at}mail.kfcc.org.tw.

Only 7 cases of pancreatic tumor with hepatocytic differentiation have been reported in the literature, including 6 cases of hepatoid carcinoma and one case of hepatoid adenoma. Diagnosis of hepatoid carcinoma depends on recognition of characteristic histological features, supported by other evidence linked to hepatic lineage including alpha-fetoprotein production, positive immunoreactivity to liver synthesized proteins, and in situ hybridization detection of albumin mRNA. In addition, a synchronous focus of carcinoma arising in pancreatic ducts, islet cells, or acinar cells is essential. We report a unique case of pancreatic tumor with exclusive hepatocytic differentiation. In this tumor, we were unable to find a synchronous focus of carcinoma arising in pancreatic ducts, islet cells, or acinar cells, ruling out the possibility of its being hepatoid carcinoma. Long term follow-up can help to determine whether this tumor is benign or malignant. The patterns of reticulin staining and immunohistochemical staining are suggestive of malignancy, but mitotic activity is low and nuclear pleomorphism is minimal.

Keywords: pancreatic neoplasm, hepatoid differentiation, carcinoma, immunohistochemistry






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