Akita J Med 38 : 75-79, 2011 33 1, 2 1 1 1 2 2 1 2 received 30 May 2011, accepted 26 July 26 2011 A case of hepatoid carcinoma of the ovary and review of the literature Yuki Shimoda 1,2, Satoko Kagabu 1, Toshiki Kawahara 1, Mitsuhiro Kato 1, Toshio Fujimoto 2 and Yukihiro Terada 2 1 Department of Obstetrics and Gynecology, Nakadori General Hospital 2 Department of Obstetrics and Gemecology, Akita University Hospital Abstract Hepatoid carcinomas are a rare group of neoplasms that are a particularly uncommon among gynecologic malignant tumors. Here, we describe a case that originally presented as occult primary cancer with multiple liver metastases. We arrived at a diagnosis of hepatoid carcinoma based on preoperative levels of serologic tumor markers and postoperative tissue analysis. We also describe our therapeutic approach for this patient. Of note, few clinical findings indicated the patient was suffering from ovarian cancer, and the differential diagnosis was difficult. In addition, we provide a review of currently available studies about the diagnosis and treatment of this disease. Key words : hepatoid carcinoma, ovarian carcinoma, α - fetoprotein, cytokeratin hepatoid carcinoma of the ovary 6 Correspondence : Yukihiro Terada, M.D. Department of Obstetrics and Genecology, Akita University Hospital, Hondo, Akita 010-8543, Japan Tel : 84-18 - 884-6163 Fax : 81-18 - 884-6447 E - mail : teraday@obgyn.med.akita - u.ac.jp 59 4 2 48 58 2008 8 11 12 3-5 cm CT computed tomography 75
34 A case of hepatoid carcinoma 1. CT : Ring Enhancement low density 3. : 3 cm 2. CT : Ring Enhancement Class V adenocarcinoma AFP alfa - fetoprotein 51.2 ng/ml CA - 125 115.0 U/ml CEA Carcinoembryonic antigen CA - 19-9 CA72-4 2 cm 3 cm AFP CK Cytokeratin 7 20 FIGO IV pt3cn1pm1, HEP 1 14 TC PTX 175 mg/ m 2 +CBDCA AUC5, d1, 4 2 12 2 AFP 68.3 ng/ml CA - 125 115.0 U/ml 3 5 CT ERCP Endoscopic Retrograde Cholangio Pancreatography 38 2 76
35 4 : Adenocarcinoma : CK7 : CK20 6. 12 24 1 14 TC 2 12 TC 3 17 ERCP 4 9 PTCD percutaneous transheptatic cholangio drainage 4 5. HE 20 20 AFP Ishikura and Scully 1 AFP 2 AFP AFP 3 AFP 59 77
36 A case of hepatoid carcinoma 2 Ring enhancement hypovascular CK7 CK20 CK7 CK20 77% 93% 4 63 22 1 5-15 Stage III FIGO 5 1 Stage Ia 16 study TC 2 6 1 Case Age Site Size cm FIGO stage Chemotherapy Follow-up 1 5 42 6 4 3 I 12 2 6 59 18 15 16 II BEP 3 7 42 11 7 7 I 36 4 8 42 6.5 III PTX 10 5 9 50 8.5 4 IIIc PTX+CDDP GEM+CDDP 24 DXR 6 10 65 12 10 6 III PTX+CDDP 2 7 59 3 4 IV PTX+CBDCA 6 8 11 42 17 6 IA PTX+CBDCA 16 9 12 64 23 17 16 IIIc CY+CDDP CY+CDDP +Radiotherapy 60 PTX+CBDCA 10 13 63 16 12 IA CY+CDDP 10 11 14 40 11 9.5 3 III 6 12 15 36 10 8 8 IIIc BEP BEP : bleomycin + etoposide + cisplatin 7 Case number 38 2 78
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