Are hepatocellular neoplasms with a Cytokeratin 7-positive pseudoglandular pattern destined for malignant transformation? A comparison of two cases

Abstract

The distinction between hepatocellular adenoma and carcinoma can be challenging. Many histologic features are proposed to be indicative of hepatocellular carcinoma including pseudoglandular formation with positive keratin staining. We hereby report two cases of hepatocellular neoplasms with the same histopathologic features that received discrepant diagnoses and thus different clinical management and follow-up. Our report raises the consideration of whether a generally accepted histologic pattern, pseudoglandular formation with keratin positivity, is truly associated with malignant transformation of a hepatocellular neoplasm and where to put its diagnostic value.

Keywords

• Hepatocellular adenoma
• Hepatocellular carcinoma
• Cytokeratin 7
• Malignant transformation