A Case of Metastatic Hepatocellular Carcinoma of the Ovary: An Immunohistochemical Study and Literature Review

Hepatocellular carcinomas rarely metastasize to the ovaries. To our knowledge, only nine cases of metastatic hepatocellular carcinoma of the ovary have been reported in the literature. Here, we present an additional case in which an ovarian lesion was the initial presentation in a 43-yearold female patient. An exploratory laparotomy revealed a left ovarian solid mass measuring 6.5×4.0×3.5 cm, with a lobulated greenish brown sectioned surface. A subsequent ultrasonogram and CT scan revealed a concurrent hepatic mass, and laboratory tests showed high serum AFP and CA125 levels. Microscopically the tumor showed predominantly solid and trabecular patterns, and intercellular canaliculi containing bile pigments. A postoperative hepatic biopsy confirmed the hepatocellular carcinoma. The main differential diagnosis involved ovarian metastasis of the hepatocellular carcinoma, the hepatoid carcinoma of the ovary with liver metastasis, and a hepatoid yolk sac tumor. Diagnosis in such cases should be reached by careful clinical evaluation and a thorough pathologic examination accompanied by a histochemical and immunohistochemical work-up.