Hepatoid Adenocarcinoma in the First Portion of the Duodenum: Report of A Case

Naoki Mashita, Hiroyuki Yokoyama, Katsumi Koshikawa, Kenji Taniguchi and Hiroyuki Suenaga

Department of Surgery, Komaki Municipal Hospital

We report the case of a 76-year old man with resectable hepatoid adenocarcinoma in the first portion of the duodenum. Gastroendoscopic tumor biopsy revealed a poorly differentiated adenocarcinoma. Abdominal CT showed a primary lesion measuring 40 mm in diameter and no evidence of invasion of surrounding strictures or distant metastasis. With the diagnosis of a malignant tumor arising from the duodenum, distal gastrectomy with resection of the first portion of the duodenum was performed. The histopathological diagnosis was hepatoid adenocarcinoma, which was immunohistochemically positive for AFP. The postoperative laboratory data revealed a high serum level of AFP (1,133 ng/ml). Hepatoid adenocarcinoma and AFP-producing tumors of duodenum are quite rare, and only 16 cases, including our case, have been reported in Japan until now. These reports suggest that the tumor has a poor prognosis, and no effective appropriate therapy has been established as yet.

Key words
hepatoid adenocarcinoma, duodenum, AFP

Reprint requests
Naoki Mashita Department of Surgery, Komaki Municipal Hospital
1-20 Jyobushi, Komaki, 485-8520 JAPAN

Accepted
July 25, 2007

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