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Case Reports: Rare disease
Metastatic mediastinal hepatoid adenocarcinoma
  1. Gayle Caruana,
  2. Robert Cachia,
  3. Sara Micallef,
  4. Matthew Sammut and
  5. Josephine Psaila
  1. Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Gayle Caruana; gayle.caruana.1{at}gov.mt

Abstract

Hepatoid adenocarcinoma (HAC) of the mediastinum is a rare extrahepatic tumour that pathologically and morphologically resembles hepatocellular carcinoma. Extrahepatic HACs primarily occur in the stomach, ovaries, lung, gallbladder, pancreas and uterus. Patients with mediastinal HAC tend to be male smokers over forty years of age. Clinical symptoms of HAC are non-specific and varied in nature; therefore, diagnosis can be challenging and often delayed. Diagnostic investigations encompass haematological, radiological and histological assessment. Surgical resection is reserved for early-stage patients; however, since diagnosis may be delayed, most patients present with metastatic disease, for which the treatment of choice is platinum-based chemotherapy.

  • cancer intervention
  • lung cancer (oncology)
  • smoking and tobacco
  • surgery
  • surgical oncology

https://doi.org/10.1136/bcr-2022-253747

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: GC is the main author and was responsible for the drafting of text and critical revision. SM is a contributor. MS was responsible for reviewing the case report. JP was the patient’s caring physician. The following authors gave final approval of the manuscript: GC, SM, MS and JP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.