title: A case report of Hepatoid Carcinoma of the Ovary with peritoneal metastases treated with cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy without systemic adjuvant therapy.
abstract: BACKGROUND
  Hepatoid Carcinoma of the Ovary (HCO) is a rare subtype of ovarian cancers where malignant cells undergo hepatoid metamorphic changes and cytologically resemble hepatocytes. There are many case reports of HCO in the literature, and patients with these tumors are almost uniformly treated with palliative debulking and conventional adjuvant chemotherapy. To our knowledge, there is only one case report of HCO complicated by peritoneal dissemination that was treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS plus HIPEC), followed by adjuvant chemotherapy.
  
  
  METHODS
  A 47-year-old female presented with vague lower abdominal pain. Work-up included imaging studies and biopsies for histopathology which confirmed the diagnosis of hepatoid ovarian carcinoma with synchronous liver metastasis and peritoneal dissemination, without evidence of extraperitoneal disease. She underwent a cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS plus HIPEC) with curative intent. Complete cytoreduction was achieved (CC-0). Postoperatively, the patient elected to forgo adjuvant therapy. She continues to be closely followed through clinical and radiological surveillance. On her most recent follow-up visit, she achieved 22 months of disease-free survival.
  
  
  CONCLUSIONS
  CRS plus HIPEC can be considered as a promising curative approach for HCO with peritoneal dissemination in absence of extraperitoneal disease. Further studies are warranted to determine the role of adjuvant chemotherapy in this relatively rare entity.
authors: Department of General Surgery, University of Illinois Hospital and Health System, Chicago, IL, United States. Electronic address: snaffouj@uic.edu.
authors: Samer A
authors: SA
authors: Naffouje
authors: Department of Pathology Edward Cancer Center, Naperville, IL, United States.
authors: Richard R
authors: RR
authors: Anderson
authors: Department of Surgical Oncology, Edward Cancer Center, Naperville, IL, United States; Division of Surgical Oncology, University of Illinois at Chicago Medical Center, Chicago, IL, United States.
authors: George I
authors: GI
authors: Salti
keywords: Case report; Cytoreductive surgery; HIPEC; Hepatoid ovarian carcinoma