Pancreatic hepatoid carcinoma: a case report

Pancreatic hepatoid carcinoma (PHC) is an extremely uncommon neoplasm of pancreas that resembles hepatocellular carcinoma (HCC). The morphological and immunohistochemical features of PHC are similar to those of HCC. The lack of specificity on clinical features of PHC makes it easy to be ignored in clinical diagnosis. And there is currently no standardized treatment for PHC. We presented a case of PHC with specific clinical examinations and treatments. The patient reported that he suffered from a history of chronic viral hepatitis B, laboratory tests showed elevated serum alpha-fetoprotein (AFP) levels. No significant liver mass was found on imaging, the contrast-enhanced abdominal computed tomography revealed a slightly nodular low-density shadow in the head of the pancreas. The patient received neoadjuvant chemotherapy combined with programmed cell death protein 1 (PD-1) antibody and he underwent radical resection of pancreatic cancer. The post-operative histopathological examination of the resection specimen revealed a diagnosis of poorly differentiated PHC. Half a month after the surgery, this patient's serum AFP dropped to within the normal range. The patient recovered without complications, and regular reexaminations showed no signs of tumor recurrence and metastasis. We analyzed the previous PHC-related literature to enhance the understanding of PHC and persistently improve PHC treatment strategies for clinicians.