Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of left adrenal hepatoid carcinoma is reported. The patient was a 57-year-old male and his chief complaint was general fatigue. Preoperative laboratory data showed markedly increased levels of alpha-fetoprotein (AFP) (30,500 ng/ml) and PIVKA-II (3.01 AU/ml). Both computed tomography (CT) and magnetic resonance computed tomography (MRCT) showed left adrenal tumor (8 x 5 cm). Angiography showed hypervascular tumor over the upper pole of the left kidney. Thoracoabdominal nephro-adrenalectomy was performed. Histological examination demonstrated hepatoid carcinoma of the left adrenal gland. AFP was positive in the tumor cells. The levels of both AFP and PIVKA-II dropped to the normal range postoperatively. Hepatoid carcinoma in the urological field is very rare. As hepatoid carcinoma in the Japanese literature in the urological field, there were only 4 cases of renal tumor, 2 cases of renal pelvic tumor, 2 cases of retroperitoneal space and 1 case of urachal tumor. This is the first report of adrenal hepatoid carcinoma in Japan.
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PMID:[Adrenal hepatoid carcinoma producing alpha-fetoprotein: a case report]. 751 22

Hepatoid adenocarcinoma is an extrahepatic tumor characterized by morphological similarities to hepatocellular carcinoma. Hepatoid adenocarcinoma of the stomach is a cancer with an extremely poor prognosis with few cases reported. Here, we describe a 75-year-old Spanish man referred to our hospital with a history of abdominal pain, general fatigue, anorexia and sickness. Initial study revealed anemia, and computed tomography scan and abdominal ultrasonography showed multiple metastases to the liver with hepatocellular carcinoma characteristics in a liver with no cirrhotic change. Further study included a serum level of alpha-fetoprotein (AFP), which resulted markedly elevated, and a conclusive esophagogastroduodenoscopy describing an elevated tumour growing through the cardia and gastroesophageal junction with foci of necrosis and haemorrhage. Gastric biopsies of the tumor revealed poorly differenciated adenocarcinoma, with hepatoid differentiation. After a diagnosis of AFP-producing hepatoid adenocarcinoma of the stomach with multiple liver metastases was made, pallitive total gastrectomy, without liver resection, was performed. Patient recovered well after surgery, and entered into a palliative systemich chemotherapy protocol. Although this illness is recognized as having poor prognosis, the patient remains alive 8 months after the operation. Accurate diagnosis of hepatoid adenocarcinoma of the stomach is important, and should be suspected under certain circumstances. We describe this rare case of hepatoid adenocarcinoma of the stomach, and review the literature concerning the clinicopathological aspects.
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PMID:Hepatoid adenocarcinoma of the stomach - a different histology for not so different gastric adenocarcinoma: a case report. 1967 68

Hepatoid adenocarcinoma (HAC) is a rare and aggressive extrahepatic tumour, morphologically mimicking hepatocellular carcinoma (HCC). However, immunophenotype and location are heterogeneous. We report the case of a 21-year-old man with HAC of the peritoneal cavity and summarize data from the 261 HAC cases published so far. The most common HAC locations were stomach (63%), ovaries (10%), lung (5%), gallbladder (4%), pancreas (4%), and uterus (4%). With the exception of gallbladder HAC, there was a male predominance (M:F = 2.4:1). Median age was 65 years (range 21-88). Fatigue, weight loss, abdominal masses, and pain were common findings. One-year survival was 55% and median overall survival 11 months (range 0.1-102). The outstanding diagnostic feature of HAC is positivity for alphafetoprotein (AFP) (88%), HepPar1 (63%), and EpCAM antibodies HEA125 or MOC31 which show no reactivity with hepatocytes. Due to the beneficial effect of sorafenib in HCC and strong activation of EGFR, ERK1 and AKT1, our patient received sorafenib. Despite temporary clinical improvement, he died 6 months after the diagnosis. The diagnostic panel of HAC should include AFP, HepPar1, and EpCAM antibodies. EpCAM reactivity excludes HCC. HAC has a poor prognosis.
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PMID:Hepatoid adenocarcinoma - review of the literature illustrated by a rare case originating in the peritoneal cavity. 2050 62