表现为原发性食管癌的转移性肝细胞癌一例罕见报告

K. Shetty, H. K. Kishan Prasad, S. Bhat, M. Mathias, V. Shetty
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引用次数: 0

摘要

肝细胞癌(HCC)转移到食道并模仿原发食道肿瘤是极其罕见的,在一些尸检系列中出现的发生率<0.4%。本文报告一例70岁男性肝细胞癌转移至食管胃交界引起诊断困境。内窥镜检查发现食管下端有溃疡性病变。从肿瘤中获得的活检标本显示肿瘤细胞的假腺排列。腹部超声示肝结节,活检证实为肝细胞癌。食管肿物免疫组化(IHC)显示Hep par 1、Glypican-3、精氨酸酶、ca19 -9、ck19、CDX2、pCEA、SATB2、Ki-67阳性,70%为HCC阳性。在这些IHC面板中,所有都是HCC的特异性标志物,但CDX2和SATB2在我们的病例中异常表达。他开始了6个周期的化疗(阿普利星125毫克,表柔比星40毫克,奥沙利铂100毫克,卡培他滨500毫克)。随访8个月后,患者症状得到改善。然而,后来,患者失去了随访。准确的预处理分期,然后提供分期适当的治疗是优化食管癌和肝细胞癌预后的关键。死前确诊的肝细胞癌食管转移病例极为罕见。我们的病例是理想的IHC,它在找到适当病例方面发挥着重要作用。此外,它证实并强调了肝细胞癌的罕见表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Metastatic hepatocellular carcinoma manifesting as primary esophageal carcinoma: A rare case report
Hepatocellular carcinoma (HCC) metastasizing to the esophagus and mimicking as a primary tumor of the esophagus is extremely rare, being present in <0.4% in some autopsy series. This report describes a case of 70-year-old male with metastatic HCC to esophagogastric junction causing diagnostic dilemma. An endoscopic examination revealed an ulcerative lesion in the lower end of the esophagus. The biopsy specimen obtained from a tumor revealed the pseudoglandular arrangement of tumor cells. Ultrasound abdomen showed liver nodule with biopsy confirming as HCC. Immunohistochemistry (IHC) of the esophageal mass showed positivity for Hep par 1, Glypican-3, Arginase, CA 19-9, CK 19, CDX2, pCEA, SATB2, and Ki-67 having 70% positivity confirming the HCC. Among these IHC panels, all are specific markers of HCC, but CDX2 and SATB2 were aberrantly expressed in our case. He was started on six cycles of chemotherapy (apristar 125 mg, epirubicin 40 mg, oxaliplatin 100 mg, and capecitabine 500 mg). After 8 months of follow-up, he was symptomatically improved. However, later, the patient was lost to follow-up. The accurate pretreatment staging and then providing stage-appropriate treatment is crucial in optimizing esophageal and hepatocellular cancer outcomes. Cases of premortem-diagnosed esophageal metastasis from HCC are extremely rare. Our case was ideal for IHC, which plays an important role in arriving at proper cases. Furthermore, it confirmed and highlighted the rare manifestations of hepatocellular carcinoma.
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