title: Primary hepatoid adenocarcinoma of the uterine corpus: A case report with immunohistochemical study for expression of liver-enriched nuclear factors.
abstract: We report a case of hepatoid adenocarcinoma of the uterus in an 86-year-old woman. Serum AFP was elevated (7824ng/ml) on admission. The surgical specimen obtained by simple hysterectomy and bilateral salpingo-oophorectomy showed an exophytic tumor, 10.5cm×6.0cm×3.7cm in size, in the uterine corpus. Microscopically, tumor cells proliferated in trabecular or cord-like arrangement, which was considered as "hepatoid appearance". An adenocarcinomatous component was intermingled. The expressions of liver-enriched transcription factors, hepatocyte nuclear factor (HNF)-1β, HNF-3, HNF-4α, and CCAAT/enhancer binding protein (C/EBP)-β, were investigated in the present case and in 19 cases of endometrioid adenocarcinoma (11 cases of Grade 2 and 8 cases of Grade 3), because these nuclear factors are involved in embryonal hepatogenesis. HNF-4α was diffusely positive in the present case, but negative in all cases of endometrioid adenocarcinoma. HNF-3 and C/EBP-β were positive for the present case and control adenocarcinoma cases (HNF-3, 36.8% and C/EBP-β, 84.2%). HNF-1β was negative for both the present case and endometrioid adenocarcinomas. This is the first report to demonstrate HNF-4α expression in this rare uterine tumor.
authors.affiliation: Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kishimoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yonemori
authors.forename: Koichiro
authors.initials: K
authors.lastname: Hirashiki
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hiroshima
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakatani
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D051557:Hepatocyte Nuclear Factor 4 / Q000378:metabolism*; D006801:Humans; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014599:Uterus / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; C496592:HNF4A protein, human; D051557:Hepatocyte Nuclear Factor 4