Molecular Profiling of a Hepatocellular Neoplasm Not Otherwise Specified (HCN-NOS) Demonstrates Distinct Molecular Features in Hepatoblastoma and HCC-Like Components

Pediatr Dev Pathol. 2024 Mar-Apr;27(2):169-175. doi: 10.1177/10935266231204788. Epub 2023 Oct 30.

Abstract

Hepatoblastomas (HB) are embryonal tumors with quiet genomes diagnosed mostly in children under 3 years of age and often cured by surgical resection and chemotherapy. However, a subset of HBs behave aggressively, displaying characteristic histologic features and higher genomic instability. Hepatocellular neoplasm-not otherwise specified (HCN-NOS) is a provisional diagnostic category for tumors exhibiting either intermediate or a combination of both HB and hepatocellular carcinoma (HCC) histological features. In this study, we characterized an HCN-NOS diagnosed in a 3-year-old patient presenting with a liver mass, in which both HB and HCC histological components were amendable to macro-dissection and molecular profiling. The spectrum of mutations, copy number changes, mRNA, and protein expression profiles within these 2 histologically distinct tumor areas demonstrate molecular heterogeneity and suggest intratumoral clonal evolution of this hepatocellular CTNNB1-mutant lesion.

Keywords: hepatoblastoma (HB); hepatoblastoma with carcinoma features (HBCs); hepatocellular carcinoma (HCC); hepatocellular neoplasm-not otherwise specified (HCN-NOS); immunohistochemistry (IHC).

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Hepatocellular* / diagnosis
  • Carcinoma, Hepatocellular* / genetics
  • Child, Preschool
  • Hepatoblastoma* / diagnosis
  • Hepatoblastoma* / genetics
  • Humans
  • Liver Neoplasms* / diagnosis
  • Liver Neoplasms* / genetics
  • Liver Neoplasms* / metabolism
  • Mutation
  • Neoplasms, Germ Cell and Embryonal*