Three cases of
hepatocellular carcinoma with ovarian
metastases discovered during the patient's life are reported. A 31-year-old woman presented with
back pain, and radiographic studies disclosed massive liver enlargement and bilateral ovarian
tumors. The second patient, a 38-year-old woman, had an
enlarged liver at the time of laparoscopic
tubal ligation, and subsequently underwent right hepatic lobectomy for
hepatocellular carcinoma. Three months later a left ovarian
tumor was detected and a total abdominal
hysterectomy with bilateral
salpingo-oophorectomy performed. The third patient, a 68-year-old woman, presented with gastrointestinal symptoms and
weight loss, and had bilateral ovarian
tumors and widespread
tumor at
laparotomy. Two patients died of their disease at 18 months and 4 years 7 months; the third patient is alive with
residual tumor at 7 months. The ovarian
tumors, which were bilateral and multinodular in two cases and focally cystic in one case, ranged from 4 to 11 cm in maximum dimension, and had yellow-
green or yellow sectioned surfaces. On microscopic examination, they were composed of cells with moderate to abundant eosinophilic cytoplasm growing diffusely and in nodules, nests, and trabeculae;
cysts or glands were conspicuous in two cases. Bile was present in one
tumor. The main differential diagnostic considerations were hepatoid
yolk sac tumor and hepatoid
carcinoma, primary or metastatic in the ovary. A variety of features, including the age of the patient, unilaterality or bilaterality of the ovarian
tumors, distribution of disease, and microscopic features of the
neoplasm, including the identification of bile, established the diagnosis. Metastatic
hepatocellular carcinoma must be included in the differential diagnosis of oxyphil cell
tumors of the ovary.