Pancreatic hepatoid carcinoma: a case report

Area of Science:

• Oncology
• Gastroenterology

Background:

• Pancreatic hepatoid carcinoma (PHC) is a rare pancreatic neoplasm with morphological and immunohistochemical similarities to hepatocellular carcinoma (HCC).
• PHC often presents with non-specific clinical features, complicating early diagnosis and lacking standardized treatment protocols.
• The rarity and diagnostic ambiguity of PHC necessitate further case studies to refine understanding and management.

Observation:

• A patient with a history of chronic viral hepatitis B presented with elevated alpha-fetoprotein (AFP) levels and a pancreatic head mass on CT.
• Imaging revealed no significant liver mass, underscoring the challenge in differentiating PHC from primary liver malignancies.
• The patient underwent neoadjuvant chemotherapy with a programmed cell death protein 1 (PD-1) antibody followed by radical pancreatic cancer resection.

Findings:

• Post-operative histopathology confirmed poorly differentiated PHC.
• Serum AFP levels normalized within two weeks after surgical resection.
• The patient experienced an uncomplicated recovery with no evidence of tumor recurrence or metastasis during follow-up.

Implications:

• This case demonstrates the potential efficacy of a neoadjuvant chemotherapy and PD-1 inhibitor regimen in managing PHC.
• Successful surgical resection and normalization of AFP levels indicate a positive prognostic outcome.
• Further research into combined treatment strategies is crucial for improving outcomes in PHC patients.