Hepatoid adenocarcinoma of the colon: a case report of a rare aggressive cancer

Hepatoid adenocarcinoma (HAC) is a rare and aggressive malignancy with histological and immunohistochemical features resembling hepatocellular carcinoma originating from non-hepatic organs. We report a case of HAC in a 34-year-old male, arising from the transverse colon, with metastases to the stomach, liver, lungs, and right femur. He presented with persistent anaemia and sub-acute intestinal obstructive symptoms. Laparotomy confirmed a transverse colon tumour infiltrating the stomach, accompanied by hepatic and peritoneal lesions. He underwent extended right hemicolectomy and en-bloc resection of the distal stomach, with a histopathological diagnosis of hepatoid adenocarcinoma. Subsequently, he suffered a pathological hip fracture and was treated with open reduction and internal fixation, followed by radiotherapy and palliative adjuvant chemotherapy. The disease progressed, leading to thoracic spine bone metastasis, necessitating further radiotherapy. He is alive, eight months post-surgery, despite a poor prognosis and disease progression.