ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Primary hepatoid carcinoma of the ovary with challenging alpha-fetoprotein status


Introduction. Primary hepatoid carcinoma of the ovary is a very rare type of tumour that resembles hepatocellular carcinoma both histologically and immunohistochemically in its staining for alpha-fetoprotein.
Case presentation. We report the case of a 49-year-old woman who presented for abdominal pain and vaginal bleeding. Computed tomography revealed a large tumour mass of the right ovary, a micro lesion in the liver of about 0.5 cm, and many nodules on the omentum. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy with tumourectomy. A right ovarian tumour mass measuring 9/8/6 cm was found. The histological diagnosis was hepatoid carcinoma of the right ovary. The serum levels of alpha- fetoprotein were high, but the immunohistochemical examination revealed a negative immunoreactivity of tumour cells for alpha-fetoprotein.
Conclusions. This is an extremely rare case of a primary hepatoid carcinoma of the ovary. The negative values of alpha-fetoprotein at immunohistochemistry do not exclude a hepatoid carcinoma. A broad panel of immunohistochemistry, including alpha-fetoprotein, HepPar(1), Glypican(3), is presented to rule out metastatic hepatocellular carcinoma in the ovary.

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Address for correspondence:
CamSpasimir T. SHOPOV
Address: Department of Pathology, MBAL “Uni Hospital” Ltd, 100 Georgi
Benkovski Str, Panagyurishte, 4500 Bulgaria
Email:; Phone: +359 878 657 256


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Shopov ST. Primary hepatoid carcinoma of the ovary with challenging alpha-fetoprotein status. Arch Balk Med Union. 2023;58(3):285-289.