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Table 2 Clinical and pathologic presentations of the CUP cases

From: Fine needle biopsy of malignant tumors of the liver: a retrospective study of 624 cases from a single institution experience

Case

Age

Gender

Imaging finding

Pertinent history

Clinical impression

Pathologic finding

Positive IHC

Negative IHC (selected pertinent negatives are listed)

Treatment

Prognosis

1

81

M

Multiple liver and lung masses

Smoking

Stage IV lung cancer

Large eosinophilic cell tumor

AE1/AE3, CK7

TTF-1, Napsin A, Synaptophysin, Chromogranin, HepPar-1, Arginase

Discharged to hospice care

Lost follow up

2

62

F

Multiple liver masses

Rectal squamous cell carcinoma, s/p surgery and chemo-radiation

Recurrent rectal carcinoma

Blue cell tumor

AE1/AE3, CK7

p40, p63, CK5/6, Synaptophysin, Chromogranin

Palliative chemotherapy

DOD 14 months

3

64

M

Multiple liver masses, abdominal and retroperitoneal lymphadenopathy

None

CUP

Blue cell tumor

CK7

CK20, HepPar-1, Arginase, Synaptophysin, Chromogranin

Palliative care

DOD 1 months

4

42

M

Multiple liver masses, retroperitoneal lymphadenopathy

Childhood seminoma diagnosed at age 12, recurred at age 22

Recurrent seminoma

Poorly differentiated adenocarcinoma

CK7

OCT3/4, CD117, CD30, PLAP, Glypican-3, CK20, CDX2, TTF-1, GATA3

Palliative care

DOD 5 weeks

5

47

M

Multiple liver, lung, and spleen masses

Smoking

CUP

Large eosinophilic cell tumor

CK7

CK20, TTF-1, Napsin A, HepPar-1, PAX8, CDX2, MelanA

Discharged to hospice care

Lost follow up

6

56

F

Multiple liver and bilateral ovarian masses, intraabdominal and mesenteric nodules

Liver cirrhosis

Mesothelioma vs. ovarian carcinoma

Poorly differentiated adenocarcinoma

CK7,

Bap-1 retained

CK20, PAX8, GATA3, ER, PR, TTF-1, WT-1

Chemo-radiation

DOD 10 months

7

59

F

Multiple liver masses, multiple lytic bone lesions

Liver cirrhosis

CUP

Scant pleomorphic tumor cells

CK7

CK20, TTF-1, Glypican 3, HepPar-1, CDX2

Discharged to hospice care

Lost follow up

8

77

M

Multiple liver and lung masses, and bone lytic lesions

None

Stage IV lung cancer

Spindle cell carcinoma

CK7

CK20, TTF-1, Napsin A, p40, CK5/6

Scheduled for oncology appointment, lost follow up

AWD 5 weeks

9

49

M

Multiple lung, liver, brain masses

Smoking and COPD

CUP

Scant pleomorphic tumor cells

CK7

Heppar-1, CK5/6, TTF-1

Palliative care

DOD 1 week

10

47

M

Unknown

Imaging study performed at outside hospital

None

Unknown

Large eosinophilic cell tumor

AE1/AE3

HepPar-1, TTF-1, CDX2, Synaptophysin, Chromogranin

Unknown

DOD 3 years

11

51

M

Multiple liver and lung masses, multiple abdominal lymphadenopathy, and omentum nodules

Liver cirrhosis

CUP

Scant pleomorphic tumor cells

AE1/AE3

CK7, CK20, HepPar1, TTF-1, Synaptophysin, Chromgranin, CD45, S100

Palliative care

DOD 3 weeks

12

31

M

Multiple liver masses, large abdominal masses

None

Cholangiocarcinoma

Blue cell tumor

AE1/AE3

SOX10, S100, Chromogranin, Synaptophysin, HepPar1, Desmin, Myogenin, CD43, CD45, Arginase,WT1, CD34, OCT3/4, CK19

Palliative care

AWD 3 weeks

  1. M Male, F Female, CUP Carcinoma of unknown primary, AWD Alive with disease, DOD Die of disease, COPD chronic obstructive pulmonary disease