Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report

Background: Pancreatic hepatoid carcinoma (PHC) is a rare and poorly characterized malignancy, with approximately 50 reported cases in the literature. Pure PHC, which lacks any features of adenocarcinoma or neuroendocrine differentiation, is a subset of this population and is extrem...

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Main Authors: Subin Punnen, Veronika Csizmok, Connor Frey, Richard Gilbert, David F. Schaeffer, Stephen Yip, Marco A. Marra, Janessa Laskin, Michael Bleszynski, Daniel R. Owen
Format: Article
Language:English
Published: Karger Publishers 2025-02-01
Series:Case Reports in Oncology
Online Access:https://karger.com/article/doi/10.1159/000544747
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author Subin Punnen
Veronika Csizmok
Connor Frey
Richard Gilbert
David F. Schaeffer
Stephen Yip
Marco A. Marra
Janessa Laskin
Michael Bleszynski
Daniel R. Owen
author_facet Subin Punnen
Veronika Csizmok
Connor Frey
Richard Gilbert
David F. Schaeffer
Stephen Yip
Marco A. Marra
Janessa Laskin
Michael Bleszynski
Daniel R. Owen
author_sort Subin Punnen
collection DOAJ
description Background: Pancreatic hepatoid carcinoma (PHC) is a rare and poorly characterized malignancy, with approximately 50 reported cases in the literature. Pure PHC, which lacks any features of adenocarcinoma or neuroendocrine differentiation, is a subset of this population and is extremely rare. Data on its management and genomic findings are limited, and further characterization may provide helpful information in caring for these patients. Case Presentation: A 42-year-old female was found to have a large, well-circumscribed mass in the body of the pancreas with elevated serum alpha-fetoprotein. Imaging demonstrated an 8.5 cm pancreatic lesion with no other disease. Endoscopic ultrasound-guided biopsy revealed a bile-producing carcinoma with morphological and immunohistochemical features consistent with hepatocellular carcinoma. She underwent a subtotal pancreatectomy and splenectomy, and pathologic evaluation confirmed a well-differentiated pure PHC confined to the pancreas. Whole genome and transcriptome analysis showed microsatellite stability, an elevated tumour mutation burden, copy number alterations in Chr19p13.3, and no mutations typically seen in pancreatic ductal adenocarcinoma (PDAC). These findings support the diagnosis of a pure hepatoid carcinoma with clinical, histopathological, and genomic characteristics resembling hepatocellular carcinoma. She remains disease free at 9 months without adjuvant therapy. Conclusion: This case demonstrates further characterization of a rare pancreatic lesion and illustrates the importance of integrated histopathological and genomic analyses in characterizing rare malignancies. Additionally, our findings suggest that pure PHC may be a distinct entity rather than a variant of PDAC.
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spelling doaj-art-96304fc507334fc29b09aa18ff98cb222025-08-20T03:09:47ZengKarger PublishersCase Reports in Oncology1662-65752025-02-0118142042810.1159/000544747Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case ReportSubin PunnenVeronika CsizmokConnor FreyRichard GilbertDavid F. SchaefferStephen YipMarco A. MarraJanessa LaskinMichael BleszynskiDaniel R. Owen Background: Pancreatic hepatoid carcinoma (PHC) is a rare and poorly characterized malignancy, with approximately 50 reported cases in the literature. Pure PHC, which lacks any features of adenocarcinoma or neuroendocrine differentiation, is a subset of this population and is extremely rare. Data on its management and genomic findings are limited, and further characterization may provide helpful information in caring for these patients. Case Presentation: A 42-year-old female was found to have a large, well-circumscribed mass in the body of the pancreas with elevated serum alpha-fetoprotein. Imaging demonstrated an 8.5 cm pancreatic lesion with no other disease. Endoscopic ultrasound-guided biopsy revealed a bile-producing carcinoma with morphological and immunohistochemical features consistent with hepatocellular carcinoma. She underwent a subtotal pancreatectomy and splenectomy, and pathologic evaluation confirmed a well-differentiated pure PHC confined to the pancreas. Whole genome and transcriptome analysis showed microsatellite stability, an elevated tumour mutation burden, copy number alterations in Chr19p13.3, and no mutations typically seen in pancreatic ductal adenocarcinoma (PDAC). These findings support the diagnosis of a pure hepatoid carcinoma with clinical, histopathological, and genomic characteristics resembling hepatocellular carcinoma. She remains disease free at 9 months without adjuvant therapy. Conclusion: This case demonstrates further characterization of a rare pancreatic lesion and illustrates the importance of integrated histopathological and genomic analyses in characterizing rare malignancies. Additionally, our findings suggest that pure PHC may be a distinct entity rather than a variant of PDAC. https://karger.com/article/doi/10.1159/000544747
spellingShingle Subin Punnen
Veronika Csizmok
Connor Frey
Richard Gilbert
David F. Schaeffer
Stephen Yip
Marco A. Marra
Janessa Laskin
Michael Bleszynski
Daniel R. Owen
Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report
Case Reports in Oncology
title Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report
title_full Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report
title_fullStr Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report
title_full_unstemmed Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report
title_short Non-Metastatic Pure Pancreatic Hepatoid Carcinoma with Genomic and Transcriptomic Analysis: A Case Report
title_sort non metastatic pure pancreatic hepatoid carcinoma with genomic and transcriptomic analysis a case report
url https://karger.com/article/doi/10.1159/000544747
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