title: Atypical Presentation of Hepatocellular Carcinoma Mimicking a Gastric Hepatoid Adenocarcinoma: A Case Report.
abstract: The diagnosis of hepatocellular carcinoma (HCC) relies on imaging tools and biopsy. It usually does not present to be a challenge.Here we report the case of a 69-year-old patient with HCC, initially mistaken for a gastric hepatoid adenocarcinoma (HAC), with a favorable outcome after neoadjuvant chemotherapy.The initial presentation (clinical signs, morphological features, and histological findings) led to the diagnosis of a gastric hepatoid adenocarcinoma. Neoadjuvant chemotherapy by epirubicin, oxaliplatin, and capecitabine protocol was administered. Biological (alpha-fetoprotein [AFP] decreased by a factor of 10), radiological (-35% RECIST), and histological (20% of necrosis) responses were observed. Complete surgical resection was then performed. The final pathological diagnosis was a well-differentiated HCC, staged pT4 N0 (0/24) R0.There are no guidelines as to how such tumors should be managed. Nonetheless, neoadjuvant chemotherapy yielded a good outcome. This observation stresses the importance of the final pathological findings and addresses the issue of neoadjuvant therapy in some cases of HCC.
authors.affiliation: From the Department of Medical Oncology (AB, CM, MB), Beaujon University Hospital (AP-HP - PRES Paris 7 Diderot), Clichy; Department of Medical Oncology (CM, DK), La Pitié Salpêtrière University Hospital (AP-HP - PRES Paris 6 Pierre et Marie Curie), Paris; and Department of Hepatology (MB), Beaujon University Hospital (AP-HP - PRES Paris 7 Diderot), Clichy, France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Becq
authors.forename: Christian
authors.initials: C
authors.lastname: Mateescu
authors.forename: David
authors.initials: D
authors.lastname: Khayat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bouattour
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D049268:Positron-Emission Tomography; D013274:Stomach Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins
chemical_list: D000509:alpha-Fetoproteins