Colon
Carcinoma
Hepatoid carcinoma
Author: Raul S. Gonzalez, M.D.
Last author update: 26 February 2021
Last staff update: 16 January 2025 (update in progress)
Copyright: 2002-2025, PathologyOutlines.com, Inc.
PubMed Search: Hepatoid carcinoma[title]
Table of Contents
Definition / general | Essential features | Terminology | Epidemiology | Sites | Clinical features | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Sample pathology report | Differential diagnosis | Board review style question #1 | Board review style answer #1Cite this page: Gonzalez RS. Hepatoid carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colontumorhepatoid.html. Accessed March 31st, 2025.
Definition / general
- Rare, aggressive subtype of adenocarcinoma that morphologically resembles hepatocellular carcinoma and produces alpha fetoprotein
Essential features
- Extremely rare subtype of colorectal carcinoma
- Resembles hepatocellular carcinoma morphologically and sometimes immunohistochemically
- Serum alpha fetoprotein may be elevated
Terminology
- Originally termed alpha fetoprotein producing tumor
Epidemiology
- More common in men
- Fewer than 20 colonic cases reported
Sites
- Hepatoid carcinoma has also been reported in other sites, including stomach, gallbladder and uterus (World J Gastroenterol 2013;19:321)
- Also ampulla, bladder, lung, ovary
Clinical features
- Can occur in patients with ulcerative colitis (World J Gastroenterol 2014;20:12657)
- Serum alpha fetoprotein may be elevated (Hepatobiliary Pancreat Dis Int 2008;7:539)
Case reports
- 42 year old man with rectal hepatoid carcinoma with liver metastases (Hepatobiliary Pancreat Dis Int 2008;7:539)
- 59 year old man with colonic α fetoprotein producing carcinoma (Dis Colon Rectum 2003;46:826)
- 71 year old man with hepatoid carcinoma colliding with liposarcoma (World J Surg Oncol 2007;5:42)
- Rectal tumor arising in ulcerative colitis (Dis Colon Rectum 2000;43:105)
- Sigmoid alpha fetoprotein producing adenocarcinoma (Pathology 1995;27:277)
Treatment
- Surgery, possibly chemotherapy (Pathol Oncol Res 2012;18:93)
Microscopic (histologic) description
- Resembles hepatocellular carcinoma, with trabecular or solid pattern of large polygonal cells with abundant eosinophilic or clear cytoplasm
- Component of traditional adenocarcinoma also often present
- Lymphovascular invasion is common (Histopathology 1997;31:47)
Microscopic (histologic) images
Images hosted on other servers:
Collision with liposarcoma
Associated with ulcerative colitis
Gastric tumor: H&E, AFP+ HepPar1- glypican3+
Positive stains
- Alpha fetoprotein, CEA, glypican 3
- Variable Hep Par1, CDX2, CK18, CK19 (Histopathology 2007;51:123)
Sample pathology report
- Sigmoid colon, resection:
- Hepatoid carcinoma of the colon, moderately differentiated (see synoptic report)
Differential diagnosis
- Metastatic hepatocellular carcinoma:
- Unusual in colon; negative for CDX2 and (usually) CK19 (J Gastroenterol Hepatol 2000;15:536)
Board review style question #1
What serum marker is often elevated in patients with hepatoid colon carcinoma?
- Alpha fetoprotein
- CA125
- CA19-9
- HER2
Board review style answer #1
