Well-differentiated gall bladder hepatoid carcinoma producing alpha-fetoprotein: a case report
Well-differentiated gall bladder hepatoid carcinoma producing alpha-fetoprotein: a case report
Journal of Medical Case Reports 2009, 3:7303
Published: August 2009
Published: August 2009
Introduction:
Gall bladder carcinoma is rare, and metastatic gall bladder carcinoma from hepatocellular carcinoma has been reported in only a few patients.
Case presentation:
We present a 73-year-old man with a history of hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma. He received transcatheter arterial chemoembolization, and was diagnosed to have an alpha-fetoprotein producing gall bladder tumor with intraluminal growth. Open cholecystectomy was performed. Pathologic examination of the lesion revealed a welldifferentiated hepatoid carcinoma. The lesion was thought most likely to be a metastatic lesion from previous hepatocellular carcinoma. His alpha-fetoprotein level dropped to normal levels five months after the surgery.
Conclusion:
This unusual intraluminal growing tumor proved to be a well-differentiated hepatoid carcinoma, most likely a metastatic lesion from previous hepatocellular carcinoma. This case reminds clinicians that in looking for likely hepatocellular carcinoma recurrence, when no detectable hepatic lesion can account for an elevated alpha-fetoprotein level, the gall bladder should be included in the search for the site of metastasis.
Introduction
Gall bladder carcinoma is a rare disease, whether primary or metastatic. It is usually diagnosed at a late stage due to asymptomatic properties when small. Sometimes carcinoma fromthe gall bladder also produces alpha-fetoprotein (a-FP) because the gall bladder shares the same embryologic origin as the liver. Only a handful of cases of a-FP producing gall bladder carcinoma had been reported in the literature, and many of them have been from Japan. Cell types of these reported cases include clear cell carcinoma, pleomorphic carcinoma or undifferentiated carcinoma. Here we present a rare case of a well-differentiated gall bladder hepatoid carcinoma producing a-FP after treatment of primary hepatocellular carcinoma (HCC).
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