{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T16:44:43Z","timestamp":1793378683268,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,9,15]],"date-time":"2017-09-15T00:00:00Z","timestamp":1505433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The primary aim of this study is to characterize hepatocellular malignant neoplasm, <jats:styled-content style=\"fixed-case\">NOS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HEMNOS<\/jats:styled-content>), a new provisional entity describing a subset of paediatric hepatocellular tumours, which have histological features of neither typical hepatoblastoma (<jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>) nor hepatocellular carcinoma (<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>The clinicopathological features of 11 patients with <jats:styled-content style=\"fixed-case\">HEMNOS<\/jats:styled-content> were analysed retrospectively. The median age and serum alpha\u2010fetoprotein level at diagnosis was 7\u00a0years and 182\u00a0000\u00a0ng\/ml, respectively. Ten patients presented with pretreatment extent of disease (<jats:styled-content style=\"fixed-case\">PRETEXT<\/jats:styled-content>) stages <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> multifocal tumours, eight with major vascular involvement, three with lung metastases and three with extrahepatic extension. The original pathology diagnoses were: <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> in seven patients, <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> in two and <jats:styled-content style=\"fixed-case\">HEMNOS<\/jats:styled-content> in two. Our pathology review of pre\u2010chemotherapy specimens showed that six tumours had equivocal\/overlapping histological features of <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>, four had predominant <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> histology along with focal <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>\u2010like histology and one had <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> histology. Seven of nine post\u2010chemotherapy resection specimens showed predominant <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>\u2010like histology. Beta\u2010catenin, glypican 3 and spalt\u2010like transcription factor 4 immunostaining showed that all the tumours had a mixed <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> immunophenotype. Telomerase reverse transcriptase immunostaining showed nuclear staining in nine of the 11 tumours. All patients received chemotherapy and achieved gross total primary tumour resection. Nine of the 11 patients were treated with established <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> chemotherapy regimens. After a median follow\u2010up of 6.1\u00a0years (range: 1.2\u201311.8\u00a0years), all patients were in remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HEMNOS<\/jats:styled-content> is a subtype of <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> with focal <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>\u2010like histology, a high\u2010risk clinical profile but favourable outcome following chemotherapy and complete tumour resection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13297","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T01:31:00Z","timestamp":1498699860000},"page":"813-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Hepatocellular malignant neoplasm, <scp>NOS<\/scp>: a clinicopathological study of 11 cases from a single institution"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1917-5543","authenticated-orcid":false,"given":"Shengmei","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Children's Hospital Los Angeles Los Angeles CA USA"},{"name":"Keck School of Medicine University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajkumar","family":"Venkatramani","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA USA"},{"name":"Division of Hematology, Oncology and Blood and Marrow Transplantation Department of Paediatrics Children's Hospital Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shveta","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology and Blood and Marrow Transplantation Department of Paediatrics Children's Hospital Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper","family":"Wang","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA USA"},{"name":"Department of Surgery Children's Hospital Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E","family":"Stein","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA USA"},{"name":"Department of Surgery Children's Hospital Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Children's Hospital Los Angeles Los Angeles CA USA"},{"name":"Keck School of Medicine University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA USA"},{"name":"Division of Hematology, Oncology and Blood and Marrow Transplantation Department of Paediatrics Children's Hospital Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,15]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"377","article-title":"Risk factors for paediatric malignant liver tumours","volume":"68","author":"Ferris ITJ","year":"2008","journal-title":"An. 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