Metastatic Hepatocellular Carcinoma of Skin Diagnosed With Hepatocyte Paraffin I and a-Fetoprotein Immunostainings

Department of Pathology, Shizuoka Municipal Shimizu Hospital, Shizuoka, Japan.
International Journal of Surgical Pathology (Impact Factor: 0.95). 06/2008; 18(5):433-6. DOI: 10.1177/1066896908318743
Source: PubMed

ABSTRACT A rare case of skin metastasis of hepatocellular carcinoma diagnosed with an aid of immunohistochemical stainings of hepatocyte paraffin 1 and a-fetoprotein is reported in this study. An 86-year-old Japanese man was admitted to our hospital due to cutaneous mass in the right chest. An incisional biopsy was performed, which showed proliferation of malignant cells with eosinophilic or clear cytoplasm arranged in solid nests. No trabecular pattern was recognized. Sebaceous carcinoma, clear cell sarcoma, malignant granular cell tumor, metastatic renal cell carcinoma, and metastatic hepatocellular carcinoma were suspected on hematoxylin and eosin preparations. An immunohistochemical study showed that the tumor cells were positive for cytokeratins, hepatocyte paraffin 1, and a-fetoprotein but negative for vimentin, desmin, a-smooth muscle actin, S-100 protein, epithelial membrane antigen, carcinoembryonic antigen, chromogranin, neuron-specific enolase, CD10, CD30, CD34, CD45, CD68, and HMB45. Metastatic hepatocellular carcinoma of the skin was diagnosed pathologically. This case suggests that skin tumors with eosinophilic cytoplasm should be examined by hepatocyte paraffin 1 and a-fetoprotein.

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    • "There are only a few case reports of each unusual metastatic site from HCC; in the diaphragma [7], in the pancreas [8], in the gall bladder [9], in the stomach [10], in the colon [11], in the adrenal gland [12], in the pleura [13], in the peritoneum [14], in the cervical lymph node [15], in the soft tissue [16], in the brain [17], in the skin [18] [19], and in the oral cavity [20]. It was very interesting that the metastatic sites of the present 2 cases (skin and oral cavity) were the first manifestations of HCC. "
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