The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Hepatoid Carcinoma of the Pancreas Presenting as Acute Pancreatitis

급성 췌장염으로 내원한 간세포양 암종 1예

  • Shin, Seung Whan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sung, You Na (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • So, Hoonsub (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Eyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Chung Ryul (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Seung-Mo (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Do Hyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 신승환 (울산대학교 의과대학 서울아산병원 내과) ;
  • 성유나 (울산대학교 의과대학 서울아산병원 병리과) ;
  • 소훈섭 (울산대학교 의과대학 서울아산병원 내과) ;
  • 송의연 (울산대학교 의과대학 서울아산병원 내과) ;
  • 오충렬 (울산대학교 의과대학 서울아산병원 내과) ;
  • 홍승모 (울산대학교 의과대학 서울아산병원 병리과) ;
  • 박도현 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2017.05.26
  • Accepted : 2017.08.18
  • Published : 2018.08.01
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Abstract

Hepatoid carcinoma is extrahepatic neoplasm showing similar morphologic, immunohistochemical features with hepatocellular carcinoma. It's a very rare disease and has been reported most frequently in the stomach. Herein, we report a case of hepatoid carcinoma of pancreas presented with acute pancreatitis. The hepatoid carcinoma was diagnosed by his needle biopsy specimen and it showed pleomorphic nuclei and predominantly eosinophilic and occasionally clear cytoplasm in hematoxylin and eosin staining, and positive for HepPar-1 and cytokeratin 19 in immunohistochemical staining. Surgical treatment seems to be the best choice, if possible. However, there is no standard regimen for palliative chemotherapy. In our case, the patient was treated with 5-Fluorouracil (5-FU), folinic acid, irinotecan, oxaliplatin (FOLFIRINOX). The response was stable disease up to 4 month of follow up.

췌장의 간세포양 암종은 전세계적으로 매우 드문 암종으로, 기존의 원발성 췌장암, 간세포암종의 췌장 전이와의 감별을 위해서 임상적, 영상학적, 병리학적 소견을 모두 검토하여 신중한 진단이 필요하다. 현재까지 확립된 치료 방법은 없는 상태로, 수술적 절제가 항암치료보다 우수한 경과를 보여 수술이 가능할 경우 수술적 치료가 필요하다. 수술이 불가능한 종양에 대한 치료법은 향후 추가적인 연구를 통하여 찾아야 하는 노력이 필요하다.

Keywords

References

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