Journal of Gastroenterology

, Volume 41, Issue 10, pp 1011–1019 | Cite as

Hepatoid carcinoma of the pancreas producing protein induced by vitamin K absence or antagonist II (PIVKA-II) and α-fetoprotein (AFP)

  • Kazuhiro Matsueda
  • Hiroshi Yamamoto
  • Yasuo Yoshida
  • Kenji Notohara
Case report


We describe a rare case of hepatoid carcinoma of the pancreas with production of protein induced by vitamin K absence or antagonist II (PIVKA-II) and α-fetoprotein (AFP). The patient was a 49-year-old woman admitted because of high serum levels of PIVKA-II (1.63 AU/ml) and AFP (623 ng/ml) and abnormal ultrasonographic findings of the pancreas, found incidentally at medical checkup. Both ultrasonography and computed tomography showed swelling of the pancreas with small areas of low density, but no hepatic lesions. The serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were not increased. A PIVKA-II and AFP-producing pancreatic cancer was strongly suspected, and total pancreatectomy was performed. Pathological examination showed that the tumor cells were arranged in trabecular and solid patterns with bile production, and were immunohistochemically positive for PIVKA-II and AFP, resembling hepatocellular carcinoma cells. The tumor was diagnosed as hepatoid carcinoma of the pancreas, and the patient has survived 48 months after initial diagnosis. It is important that hepatoid carcinoma be considered as a possible malignant tumor of the pancreas, and simultaneous measurement of the serum levels of AFP and PIVKA-II will enable earlier diagnosis. This is the first report describing hepatoid carcinoma of the pancreas producing PIVKA-II.

Key words

hepatoid carcinoma pancreatic cancer protein induced by vitamin K absence or antagonist II (PIVKA-II) 


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Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Kazuhiro Matsueda
    • 1
  • Hiroshi Yamamoto
    • 1
  • Yasuo Yoshida
    • 2
  • Kenji Notohara
    • 3
  1. 1.Department of GastroenterologyKurashiki Central HospitalKurashikiJapan
  2. 2.Department of SurgeryKurashiki Central HospitalKurashikiJapan
  3. 3.Department of PathologyKurashiki Central HospitalKurashikiJapan

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