Diagnostic Value of Albumin Gene Expression in Liver Tumors: Case Report and Review of the Literature

• Published in: Mayo Clinic proceedings Vol. 73; no. 6; pp. 533 - 536
• Main Authors: Rajkumar, S. Vincent, Richardson, Ronald L., Goellner, John R.
• Format: Journal Article
• Language: English
• Published: Rochester, MN Elsevier Inc 01.06.1998; Mayo Medical Ventures; Elsevier Limited
• Subjects: Aged; Biological and medical sciences; Biomarkers, Tumor - genetics; Carcinoma, Hepatocellular - genetics; Carcinoma, Hepatocellular - pathology; Carcinoma, Renal Cell - genetics; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - secondary; Diagnosis, Differential; Gastroenterology. Liver. Pancreas. Abdomen; Humans; In Situ Hybridization; Kidney Neoplasms - genetics; Kidney Neoplasms - pathology; Liver - pathology; Liver Neoplasms - genetics; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Neoplasms, Multiple Primary - genetics; Neoplasms, Multiple Primary - pathology; RNA, Messenger - genetics; Sensitivity and Specificity; Serum Albumin - genetics; Tumors; mRNA; AFP; ISH; Human; Molecular hybridization; Liver; In situ; Hepatic disease; Gene expression; α-Fetoprotein; Differential diagnostic; Case study; Digestive diseases; Genetics; Tumor; Molecular biology
• ISSN: 0025-6196; 1942-5546
• DOI: 10.4065/73.6.533

Management of a solitary liver mass necessitates reliable distinction between primary hepatocellular carcinoma and metastatic lesions. The histologic differentiation can be difficult even with special stains such as α-fetoprotein, cytokeratin, and carcinoembryonic antigen. Albumin is a specific product of hepatocytes, and in situ hybridization to reveal albumin messenger RNA (mRNA) is highly specific and sensitive for the diagnosis of primary hepatocellular carcinoma. This technique can be used on histopathologic specimens and in cytologic diagnosis. Herein we describe a patient with synchronous renal and hepatic masses, in whom the distinction had to be made between metastatic renal cell carcinoma and two separate primary tumors—one in the liver and one in the kidney. In situ hybridization for albumin mRNA proved helpful in making this distinction. In addition, we review the literature on the diagnostic use of albumin gene expression in liver tumors.