TY - JOUR

T1 - Disseminated Primary Uterine Hepatoid Adenocarcinoma with α-Fetoprotein Production Demonstrated on 18F-FDG PET/CT

AU - Dejanovic, Danijela

AU - Boennelycke, Marie

AU - Amtoft, Annemarie Gjelstrup

AU - Christensen, Charlotte Birk

AU - Wetterstroem, Victoria

AU - Loft, Annika

AU - Noettrup, Trine Jakobi

N1 - Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022

Y1 - 2022

N2 - We present the18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/com-puted tomography (PET/CT) findings in a 57-year-old woman with post-menopausal bleeding diagnosed with hepatoid adenocarcinoma (HAC) with a primary tumour in the uterine corpus and a highly elevated level of serum-α-fetoprotein (S-AFP) at presentation. HAC is a variant of adenocar-cinoma with hepatic differentiation representing a heterogeneous group of neoplasms that morpho-logically and immunphenotypically resemble hepatocellular carcinoma (HCC) but are of extrahe-patic origin. Microscopically, they are usually poorly differentiated adenocarcinomas proliferating in solid sheets or in a trabecular or cord-like arrangement. Primary uterine HAC is exceedingly rare with a general poor prognosis, and data is sparse and limited to case reports, making the clinical management challenging. Various primary anatomical sites have been reported in the literature, with the stomach being the most common primary site.18F-FDG PET/CT plays an important role in staging and follow-up in many gynecological malignancies including uterine corpus cancer. To the best of our knowledge, this is the first report describing a primary uterine hepatoid adenocarcinoma with metastases to bone, vagina and lymph nodes on18F-FDG PET/CT. By utilizing the ability of PET to detect early metabolic changes prior to visible structural changes on conventional imaging, this case illustrates a potential role of18FDG-PET/CT in the staging of primary endometrial HAC by depicting distant metastasis that is not readily identifiable on CT alone.

AB - We present the18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/com-puted tomography (PET/CT) findings in a 57-year-old woman with post-menopausal bleeding diagnosed with hepatoid adenocarcinoma (HAC) with a primary tumour in the uterine corpus and a highly elevated level of serum-α-fetoprotein (S-AFP) at presentation. HAC is a variant of adenocar-cinoma with hepatic differentiation representing a heterogeneous group of neoplasms that morpho-logically and immunphenotypically resemble hepatocellular carcinoma (HCC) but are of extrahe-patic origin. Microscopically, they are usually poorly differentiated adenocarcinomas proliferating in solid sheets or in a trabecular or cord-like arrangement. Primary uterine HAC is exceedingly rare with a general poor prognosis, and data is sparse and limited to case reports, making the clinical management challenging. Various primary anatomical sites have been reported in the literature, with the stomach being the most common primary site.18F-FDG PET/CT plays an important role in staging and follow-up in many gynecological malignancies including uterine corpus cancer. To the best of our knowledge, this is the first report describing a primary uterine hepatoid adenocarcinoma with metastases to bone, vagina and lymph nodes on18F-FDG PET/CT. By utilizing the ability of PET to detect early metabolic changes prior to visible structural changes on conventional imaging, this case illustrates a potential role of18FDG-PET/CT in the staging of primary endometrial HAC by depicting distant metastasis that is not readily identifiable on CT alone.

KW - AFP

KW - FDG

KW - hepatoid adenocarcinoma

KW - PET/CT

KW - uterus

U2 - 10.3390/diagnostics12061447

DO - 10.3390/diagnostics12061447

M3 - Journal article

C2 - 35741257

AN - SCOPUS:85132283835

VL - 12

JO - Diagnostics

JF - Diagnostics

SN - 2075-4418

IS - 6

M1 - 1447

ER -