Brain, Metastatic hepatocellular carcinoma [LMP35212]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Metastatic hepatocellular carcinoma
Species: 
Human
Organ System: 
Central Nervous System
Gender: 
Male
Age: 
55 years
Diagnosis Code: 
ICD-10: C79.3 | ICD-O: 8000/6
Slide Contributor Information
Gao, A., Munoz, D.

Keywords

liver, metastasis, HCC, HCV, cirrhosis

Clinical History

55-year-old man presents with headache, nausea, and vomiting. Neuroimaging shows a cerebellar mass causing hydrocephalus. Past medical history includes hepatitis C.

Clinical Discussion

Hepatocellular carcinoma (HCC) is a primary malignant tumour of the liver with hepatocytic differentiation. Chronic viral hepatitis is the leading cause of HCC worldwide and the majority of HCCs arise in cirrhosis. Brain metastasis is extremely rare and associated with poor prognosis. Microscopically, architectural patterns of HCC include trabecular, pseudoglandular / acinar, compact, and spindled (sarcomatoid). Tumour cells resemble hepatocytes: polygonal shape, round vesicular nuclei, and prominent nucleoli. Clear cells may be present, due to accumulation of glycogen, water, or fat. Cytoplasmic inclusions, such as Mallory bodies, may be seen. Arginase-1, Hep Par-1 (see Related Content), and glypican-3 are hepatocellular markers of varying sensitivity and specificity.

Related Content

Hep Par-1 stain