Hepatocellular carcinoma presenting primarily as ovarian metastasis in Egyptian woman: a case report and literature review

  • Authors

    • Amal Abd El hafez Pathology department, faculty of medicine, Mansoura University, Egypt.
    2014-06-04
    https://doi.org/10.14419/ijm.v2i2.2699

  • Abstract

    Metastatic spread of hepatocellular carcinoma (HCC) to the ovary is an extremely rare event especially if presented in absence of a known hepatic primary and/or in a living patient. Here, a case of metastatic HCC to the ovary is presented in 54-years living Egyptian female patient in whom the ovarian lesion was the primary presentation associated with elevated serum alpha-fetoprotein level. Ultrasonography revealed 2 two focal hepatic lesions. The diagnosis was based on the simultaneous presence of ovarian and hepatic lesions, bilaterality, the trabecular growth pattern, cytological features, presence of bile and Periodic acid Sciff-positive, diastase-resistant cytoplasmic granules on microscopic examination and immuno-histochemistry. Metastatic HCC must be included in the differential diagnosis of hepatoid and oxyphil cell tumors of the ovary.

    Keywords: Hepatocellular Carcinoma, Ovarian Metastasis, Hepatoid, Oxyphil, Immuno-histochemistry.

  • References

    1. McCluggage WG, Wilkinson N (2005) Metastatic neoplasms involving the ovary: a review with an emphasis on morphological and immunohistochemical features. Histopathol 47(3), 231-247.
    2. Chang TC, Changchien CC, Tseng CW, Lai CH, Tseng CJ, Lin SE, Wang CS, Huang KJ, Chou HH, Ma YY, Hsueh S, Eng HL, Fan HA (1997) Retrograde lymphatic spread: a likely route for metastatic ovarian cancers of gastrointestinal origin. Gynecol Oncol 66, 372-377.
    3. Kiyokawa T, Young RH, Scully RE (2006) Krukenberg tumors of the ovary: a clinicopathologic analysis of 120 cases with emphasis on their variable pathologic manifestations. Am J Surg Pathol 30(3), 277-299.
    4. Kim MJ (2005) a case of metastatic hepatocellular carcinoma of the ovary: an immunohistochemical study and literature review. Korean J Pathol 39, 287-290.
    5. Young RH (2007) From Krukenberg to today: the ever present problems posed by metastatic tumors in the ovary. Part II. Adv Anat Pathol 14(3), 149- 177.
    6. Lee JM, Park KM, Lee SY Choi J, Hwang DW, Lee YJ (2011) Metastasis of hepatocellular carcinoma to the ovary: a case report and review of the literature. Gut Liver 5(4), 543-547.
    7. Seidman JD, Kurman RJ, Ronnett BM (2003) Primary and meta-static mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol 27(7), 985-993.
    8. Young RH, Gersell DJ, Clement PB, Scully RE (1992) Hepatocellular carcinoma metastatic to the ovary: a report of three cases discovered during life with discussion of the differential diagnosis of hepatoid tumors of the ovary. Hum Pathol 23, 574-580.
    9. Pitman MB, Triratanachat S, Young RH, Oliva E (2004) Hepato-cyte paraffin 1 antibody does not distinguish primary ovarian tumors with hepatoid differentiation from metastatic hepatocellular carcinoma. Int J Gynecol Pathol 23(1), 58-64.
    10. Khunamornpong S, Siriaunkgul S, Chunduanb A (1999) Metastatic hepatocellular carcinoma of the ovary. Int J Gynecol& Obstet 64, 189-191.
    11. de Groot ME, Dukel L, Chadha-Ajwani S, Metselaar HJ, Tilanus HW, Huikeshoven FJ (2000) Massive solitary metastasis of hepatocellular carcinoma in the ovary two years after liver transplantation. Eur J Obstet Gynecol Reprod Biol 90, 109-111.
    12. Kim TH, Cheung DY, Chung WB, Son DK, Jo DH, Chung JS, Kim HK, Kim JK, Sun HS, Kang CS (2004) A case of metastatic hepatocellular carcinoma of the ovary. Korean J Gastroenterol 43, 215-218.
    13. Oortman EH, Elliott JP (1983) Hepatocellular carcinoma metastatic to the ovary: a case report. Is J Obstet Gynecol 146, 715-717.
    14. Pandey M, Truica C (2011) Hepatoid carcinoma of the ovary. J Clin Oncol 29(15):e446-8. doi: 10.1200/JCO.2010.33.6321.
    15. Cascales Campos PA, Gil Martinez J, Torroba A, Machado F, Parrila Paricio P (2013) peritoneal dissemination of hepatoid carcinoma of the ovary treated with cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy. Case Rep Med 283295. doi: 10.1155/2013/283295.
    16. Gopaldas R, Kunasani R, Plymyer MR, Bloch RS (2005) Hepatoid malignancy of unknown origin: a diagnostic conundrum: review of literature and case report of collision with adenocarcinoma. Surg Oncol 14(1), 11-25.
    17. Choudhury M, Pujani M, Singh SK, Biswas R (2008) Oxyphilic clear cell carcinoma ovary. J Postgrad Med 54(4), 326-327.
    18. Lazaro J, Rubio D, Repolles M, Capote L (2007) Hepatoid carcinoma of the ovary and management. Acta Obstet Gynecol Scand 86(4), 498-499.
    19. Ulbright TM (2005) Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues. Mod Pathol 18 Suppl 2, S61-79.
    20. Young RH, Scully RE (1987) Oxyphilic clear cell carci-noma of the ovary. A report of nine cases. Am J Surg Pathol 11(9), 661-667.
    21. Kim YT, Kim SW, Yoon BS, Kim SH, Kim JH, Kim JW, Cho NH (2007) An ovarian steroid cell tumor causing virilization and massive ascites. Yonsei Med J 48(1), 142-146.
    22. Jiang W, Tao X, Fang F, Zhang S, Xu C (2013) Benign and malignant ovarian steroid cell tumors, not otherwise specified: case studies, comparison, and review of the literature. J Ovarian Res 6(1):53. doi: 10.1186/1757-2215-6-53.

  • Downloads

  • How to Cite

    Abd El hafez, A. (2014). Hepatocellular carcinoma presenting primarily as ovarian metastasis in Egyptian woman: a case report and literature review. International Journal of Medicine, 2(2), 43-46. https://doi.org/10.14419/ijm.v2i2.2699

    Received date: 2014-05-04

    Accepted date: 2014-05-31

    Published date: 2014-06-04