Hepatocellular carcinoma, syncytial giant cell: a novel variant in children: a case report.
ABSTRACT Hepatocellular carcinoma (HCC) is the second most common primary malignant hepatic tumor in children. It often develops in patients with underlying liver disease. We report the clinicopathologic features of an unusual HCC occurring in an infant who presented with features of Cushing's syndrome due to bilateral adrenal hyperplasia. The tumor is characterized by epithelial syncytial giant cells. Giant cell carcinoma of the liver has been previously reported, but the cells were osteoclast-like (ie, mesenchymal type) and not epithelial type as it is in this patient. We propose to use the term HCC, syncytial giant cell type, to denote this apparently novel lesion.
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ABSTRACT: Hepatocellular carcinoma (HCC) often develops in patients with underlying liver disease, yet HCC with syncytial giant cells (SGCs) is extremely rare. Herein, we report a 55-year-old man with a 6-year history of alcoholic cirrhosis who during his regular checkup presented with marked elevation of alpha-fetoprotein. Clinical examination and imaging analyses revealed a tumor-like lesion in segment 4 of the liver, which was removed by limited wedge resection. Histological analysis by hematoxylin and eosin staining indicated pleomorphic and atypical nodules, with some SGCs, embedded within the boundaries of the neoplastic lesion. The adjacent liver parenchyma showed microvesicular steatosis, pericellular fibrosis, and moderate hemosiderin accumulation (grade 2, as determined by Prussian blue iron stain) in hepatocytes and Kupffer cells but no copper accumulation (as determined by orcein stain). Immunohistochemical analysis showed hepatocyte antigen-positive staining for the neoplastic cells and SGCs. The diagnosis was made for cirrhosis-related HCC with SGCs. The previous reports of pleomorphic HCC have featured osteoclast-like (i.e., mesenchymal type) giant cells, making this case of epithelial type giant cells very rare. The patient's 6-month history of hypericum perforatum/St John's wort self-medication may have prompted the cirrhosis or HCC progression or the unusual SGC manifestation.World Journal of Gastroenterology 02/2014; 20(8):2113-6. DOI:10.3748/wjg.v20.i8.2113 · 2.43 Impact Factor
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ABSTRACT: The overall focus of this review is the characterization and functional role of cell–cell fusions in connection with human endogenous retroviruses (HERV ) in cancer. Examples of multinucleated cells presented include placental syncytiotrophoblasts, muscle myotubes, bone osteoclasts involved in normal human development and cell–cell fusions detected in tumors. Examples of multinucleated cells in various cancers include germ cell tumors, glioblastoma, melanoma, lung, breast, ovarian and endometrial carcinomas. The role of different HERV-envelope proteins mediating fusion or regulation of cells in tumors is highlighted. Although multinucleated cells are detected in various tumors, their origin, functional role and overall cellular fate are ambiguous. The effect of multiple cancer cells fusing and in contrast cancer cells fusing with somatic cells is also discussed. Understanding tumorigenesis has to ultimately link the knowledge between the function and action of multinucleated cells, cell fusion, HERVs, retroviruses and cell signalling pathways. KeywordsCancer-cell-cell fusions-HERV-multinucleated cells-polyploidy-retrovirus-syncytin-virus11/2010: pages 395-426;