J Korean Soc Radiol.  2016 Dec;75(6):495-500. 10.3348/jksr.2016.75.6.495.

Imaging Findings of Hepatoid Adenocarcinoma of the Small Bowel: A Case Report

• Park JW
• Kim KA
• Jung SG

• KMID: 2360438
• DOI: http://doi.org/10.3348/jksr.2016.75.6.495

Abstract

Hepatoid adenocarcinoma is a rare extrahepatic tumor defined as having a morphologic and immunohistochemical similarity to hepatocellular carcinoma. In this case report, we describe a patient with hepatoid adenocarcinoma of the jejunum with multiple liver metastases that developed in the absence of risk factors. We describe the radiologic findings including those of dynamic computed tomography and small bowel follow-through. To the best of our knowledge, only two cases of hepatoid adenocarcinoma of the small bowel have been reported in patients with inflammatory bowel disease.

MeSH Terms

Adenocarcinoma*
Carcinoma, Hepatocellular
Humans
Inflammatory Bowel Diseases
Jejunal Neoplasms
Jejunum
Liver
Liver Neoplasms
Neoplasm Metastasis
Risk Factors
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 48-year-old man with a liver mass detected on ultrasonography. A. Multiphase contrast enhanced CT images show multiple, large liver masses with heterogeneous and delayed peripheral enhancement (pre contrast CT; 35 HU, arterial phase; 69 HU, portal phase; 79 HU, and delayed phase; 69 HU, center of the mass 56 HU in all phases). HU = Hounsfield units B. Coronal reformatted post contrast enhanced CT scan shows an irregular mass in the proximal jejunum (arrows), enlarged regional lymph nodes (arrowheads), and a huge liver mass (curved arrows). C. Small bowel follow-through shows a focal luminal mass with shouldering and irregular mucosal destruction (arrows). D. PET shows multiple focal strong FDG uptakes in both lobes with a large FDG defect lesion (curved arrow) in the right lobe of the liver and focal and marked wall thickening of the small bowel (arrow) with strong FDG uptake. E. Gross specimen shows a huge, ill-defined, ulcerated mass (arrow), measuring about 8 × 10 cm and multiple enlarged lymph node (arrowheads) with a necrotic surface. FDG = fluorodeoxyglucose, PET = positron emission tomography F. Histologic specimen shows diffuse positivity for antihepatocyte specific antigen and polyclonal carcinoembryonic antigen (CEA) antibody. H&E = hematoxylin and eosin

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