Metastatic Hepatocellular Carcinoma Represents an Important but Rare Pitfall in the Diagnostic Evaluation of ER Negative Ovarian Malignancy: A Case Report.

Metastatic hepatocellular carcinoma (HCC) to the ovary is a rare and challenging histopathological diagnosis in the absence of the relevant clinical history. The differential diagnoses of a hepatoid tumor in the ovary are extensive, and correct diagnosis requires well-considered clinical-pathologic correlation. Familiarity with the diverse architectural patterns and immunophenotype of HCC is essential; however, even in the setting of known hepatic disease, a well-developed pseudoglandular pattern may be a convincing morphologic mimic of a primary surface epithelial ovarian malignancy. We describe a diagnostically challenging case of a 50-year-old woman with metastatic HCC exhibiting a prominent pseudoglandular pattern mimicking primary endometrioid adenocarcinoma, and an approach to overcome this important pitfall.