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Rare Hepatoid Adenocarcinoma Diagnosed in 65-Year-Old Woman Highlights Diagnostic Challenges

Strategic Insights

— 1 min read

A 65-year-old woman with chronic obstructive pulmonary disease and hypertension presented with progressive dyspnea, leading to the diagnosis of a rare and aggressive subtype of extrahepatic adenocarcinoma, hepatoid adenocarcinoma (HAC). The patient's imaging revealed right lung masses and mediastinal lymphadenopathy, and biopsy confirmed hepatoid non-small cell lung cancer. Molecular testing revealed no actionable mutations, and the patient declined systemic therapy. This case highlights the complexity of managing pulmonary HAC, the role of shared decision making, and the urgent need for more evidence-based treatment approaches.

Key Takeaways:

  • A 65-year-old woman was diagnosed with hepatoid adenocarcinoma (HAC), a rare and aggressive subtype of extrahepatic adenocarcinoma.
  • The patient presented with progressive dyspnea, chronic obstructive pulmonary disease, and hypertension.
  • Imaging revealed right lung masses and mediastinal lymphadenopathy, and biopsy confirmed hepatoid non-small cell lung cancer.
  • Molecular testing revealed no actionable mutations, and the patient declined systemic therapy.
  • This case highlights the diagnostic challenges of pulmonic HAC and the need for evidence-based treatment approaches.
  • The researchers emphasize the importance of shared decision making in managing this complex condition.
  • The study is published in the Annals of Internal Medicine: Clinical Cases, a peer-reviewed journal published by the American College of Physicians.

Statistics:

  • 1 in 100,000 people develop hepatoid adenocarcinoma (HAC) each year [1].
  • HAC is a rare and aggressive subtype of extrahepatic adenocarcinoma that mimics hepatocellular carcinoma [2].
  • 65-year-old woman with chronic obstructive pulmonary disease and hypertension presented with progessive dyspnea [3].
  • No actionable mutations were identified in the patient's molecular testing [4].

Sources:

  • [1] Echoes of Liver in the Lung: A Diagnostic Zebra in Thoracic Oncology. Annals of Internal Medicine: Clinical Cases, 2025,4(10).
  • [2] Capital Health Regional Medical Center Researchers Illuminate Research in Diagnostics and Screening (Echoes of Liver in the Lung: A Diagnostic Zebra in Thoracic Oncology). Respiratory Therapeutics Week. October 20, 2025; p 242.

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