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Malignant transformation of a β-catenin inflammatory adenoma due to an S45 β-catenin-activating mutation present 12 years before.

Abstract
In 1984, a 24-year-old woman underwent a right hepatectomy after a 17-cm nodule, diagnosed as a hepatocellular adenoma with some atypia. The resection was incomplete. Follow-up was interrupted. In 1996, a computed tomographic scan revealed a large multifocal hepatocellular carcinoma confirmed on biopsies. The patient died the same year. We reviewed these nodules using immunohistochemistry and gene sequencing. C-reactive protein was overexpressed in the tumor resected in 1984. Glutamine synthetase was heterogeneous in the tumor, with a few tumor nuclei expressing β-catenin. Glypican and heat shock protein 70 were negative. In this β-catenin-activated inflammatory hepatocellular adenoma, S45 β-catenin-activating mutation was detected on fixed tissue, embedded in paraffin without TERT promoter mutation. An identical CTNNB1 mutation was identified in the 1996 liver tumor together with a TERT promoter mutation showing that this hepatocellular carcinoma results from the malignant transformation of the initial β-catenin inflammatory adenoma.
AuthorsChristine Sempoux, Bettina Bisig, Gabrielle Couchy, Charles Balabaud, Jessica Zucman-Rossi, Paulette Bioulac-Sage
JournalHuman pathology (Hum Pathol) Vol. 62 Pg. 122-125 (Apr 2017) ISSN: 1532-8392 [Electronic] United States
PMID27984126 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2017 Elsevier Inc. All rights reserved.
Chemical References
  • Biomarkers, Tumor
  • CTNNB1 protein, human
  • beta Catenin
Topics
  • Adenoma (genetics, pathology, surgery)
  • Biomarkers, Tumor (analysis, genetics)
  • Biopsy
  • Carcinoma, Hepatocellular (drug therapy, genetics, pathology)
  • Cell Transformation, Neoplastic (genetics, pathology)
  • DNA Mutational Analysis
  • Fatal Outcome
  • Female
  • Hepatectomy
  • Humans
  • Immunochemistry
  • Liver Neoplasms (drug therapy, genetics, pathology, surgery)
  • Mutation
  • Neoplasm, Residual
  • Time Factors
  • Treatment Outcome
  • Young Adult
  • beta Catenin (genetics)

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