Hepatoid carcinoma of the pancreas mimicking neuroendocrine tumor
Images in Clinical Medicine

Hepatoid carcinoma of the pancreas mimicking neuroendocrine tumor

Kentaro Fukushima, Akira Kobayashi

First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan

Correspondence to: Akira Kobayashi, MD, PhD. First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan. Email: kbys@shinshu-u.ac.jp.

Submitted Jul 09, 2018. Accepted for publication Sep 25, 2018.

doi: 10.21037/hbsn.2018.10.11


A 44-year-old man was admitted to our hospital for further investigation of a tumor in the pancreatic head. He had no symptoms or chronic liver diseases. Pancreatic hormones, CEA, and CA19-9 were normal. Serum alpha-fetoprotein and des-gamma-carboxy prothrombin were not assessed.

A contrast-enhanced abdominal CT scan revealed a well-circumscribed, comparatively hypervascular mass during the arterial phase of imaging (panel A), suggesting a neuroendocrine tumor of the pancreas.

The patient underwent tumor enucleation. A macroscopic examination revealed a 19 mm × 18 mm solid tumor with a fibrous capsule and a nodule-in-nodule appearance (panel B). A H&E staining revealed the tumor cells contained abundant eosinophilic cytoplasm and exhibited a trabecular pattern with bile production (arrow heads) (panel C, 50×). Immunohistological examinations revealed the tumor cells were positive for Hep Par 1 and glypican 3 (panel D, 50×) and negative for synaptophysin and chromogranin A. We diagnosed the tumor as a hepatoid carcinoma of the pancreas.


Acknowledgements

The authors thank Dr. Takeshi Uehara, a pathologist at the Department of Laboratory Medicine, Shinshu University Hospital, for his help with the pathological interpretation and final diagnosis.


Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Informed Consent: Written informed consent was obtained from the patient for publication of this manuscript and any accompanying images.

Cite this article as: Fukushima K, Kobayashi A. Hepatoid carcinoma of the pancreas mimicking neuroendocrine tumor. Hepatobiliary Surg Nutr 2018;7(6):501-502. doi: 10.21037/hbsn.2018.10.11