{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:05:24Z","timestamp":1789992324602,"version":"4.0.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Synopsis<\/jats:title>\n                    <jats:p>Hepatoid carcinoma of the ovary (HCO) exhibits morphological and immunophenotypic features highly similar to those of hepatocellular carcinoma. Immunohistochemical staining for alpha-fetoprotein, hepatocyte paraffin antigen 1, and glypican-3 is an important auxiliary approach for the clinical diagnosis of HCO. Currently, most treatment regimens for this disease are developed with reference to clinical management protocols for high-grade epithelial ovarian cancer. Hepatoid carcinoma of the ovary (HCO) is an extremely rare, distinct histological subtype of primary ovarian adenocarcinoma that exhibits remarkable clinicopathological similarity to hepatocellular carcinoma (HCC). The histogenetic origin of HCO remains controversial, with hypotheses proposing derivation from ovarian surface epithelium or extragonadal non-germ cell precursors. This neoplasm primarily affects postmenopausal women, typically presenting as unilateral or bilateral cystic-solid ovarian masses accompanied by significantly elevated serum alpha-fetoprotein (AFP) levels. HCO is characterized by high biological aggressiveness, with most cases diagnosed at an advanced stage leading to a uniformly poor prognosis. Owing to its extreme rarity, existing research on HCO is largely limited to sporadic case reports. This systematic review aggregates eligible HCO cases published from 1987 to January 2026, conducts pooled analysis and comprehensive synthesis of clinical characteristics, pathological features, treatment strategies and molecular findings, with the aim of providing evidence-based references for clinical diagnosis and therapeutic decision-making, and establishing a theoretical foundation for future translational research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1970223","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:08:16Z","timestamp":1789988896000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatoid carcinoma of the ovary: a literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Mingyuan","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Gynecology, Jiaozhou Central Hospital of Qingdao","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieqiong","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Jiaozhou Central Hospital of Qingdao","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengjuan","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Jiaozhou Central Hospital of Qingdao","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19871201)60:11<2775::aid-cncr2820601130>3.0.co;2-s","article-title":"Hepatoid carcinoma of the ovary. A newly described tumor","volume":"60","author":"Ishikura","year":"1987","journal-title":"Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1996.0293","article-title":"Combined ovarian serous papillary and hepatoid carcinoma","volume":"63","author":"Scurry","year":"1996","journal-title":"Gynecol Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/01.PGP.0000055173.04957.66","article-title":"Hepatoid carcinoma of the ovary: a report of three cases admixed with a common surface epithelial carcinoma","volume":"22","author":"Tochigi","year":"2003","journal-title":"Int J Gynecol Pathol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-009-1259-x","article-title":"Hepatoid carcinoma of the ovary with sex cord stromal tumor: a previously unrecognized association","volume":"281","author":"D'Antonio","year":"2010","journal-title":"Arch Gynecol Obstet"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2011.01622.x","article-title":"Alpha-fetoprotein producing ovarian clear cell carcinoma with a neometaplasia to hepatoid carcinoma arising from endometriosis: a case report","volume":"37","author":"Takahashi","year":"2011","journal-title":"J Obstet Gynaecol Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.71496","article-title":"Hepatoid carcinoma of the ovary: case report, clinical management, and insights from literature review","volume":"13","author":"Zhang","year":"2025","journal-title":"Clin Case Rep"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-199107000-00009","article-title":"Hepatoid carcinoma of the ovary: a case report","volume":"10","author":"Matsuta","year":"1991","journal-title":"Int J Gynecol Pathol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(98)70092-4","article-title":"Primary hepatoid carcinoma of ovary in pregnancy","volume":"179","author":"Maymon","year":"1998","journal-title":"Am J Obstet Gynecol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1827.1999.00840.x","article-title":"An autopsy case of hepatoid carcinoma of the ovary with PIVKA-II production: immunohistochemical study and literature review","volume":"49","author":"Senzaki","year":"1999","journal-title":"Pathol Int"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4103\/0971-5851.195744","article-title":"A rare case of hepatoid carcinoma of the ovary with pancytopenia and hypocellular marrow","volume":"37","author":"Lakhotia","year":"2016","journal-title":"Indian J Med Paediatr Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1631424","article-title":"Case Report: A rare case of hepatoid carcinoma of the ovary with genomic profiling and long-term follow-up: diagnostic and therapeutic perspectives","volume":"15","author":"Zuo","year":"2025","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/cac2.12336","article-title":"Genomic profiling and the impact of MUC19 mutation in hepatoid adenocarcinoma of the stomach","volume":"42","author":"Zhu","year":"2022","journal-title":"Cancer Commun (Lond)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2017-0485-RS","article-title":"Hepatoid carcinoma of the ovary: clinical, histopathologic, and immunophenotypic features","volume":"143","author":"Acosta","year":"2019","journal-title":"Arch Pathol Lab Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2018.07.037","article-title":"Expression of RNA-binding protein LIN28 in classic gastric hepatoid carcinomas, gastric fetal type gastrointestinal adenocarcinomas, and hepatocellular carcinomas: An immunohistochemical study with comparison to SALL4, alpha-fetoprotein, glypican-3, and Hep Par1","volume":"214","author":"Zhao","year":"2018","journal-title":"Pathol Res Pract"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1177\/10668969241260811","article-title":"Whole-exome sequencing identifies germline BLM mutation in ovarian hepatoid adenocarcinoma with favorable response to niraparib and anlotinib combination therapy-A case report and literature review","volume":"33","author":"Zhang","year":"2025","journal-title":"Int J Surg Pathol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1159\/000325560","article-title":"Cytologic features of hepatoid carcinoma of the ovary: a case report with immunocytologic evaluation of HepPar1","volume":"52","author":"Tejerina Gonz\u00e1lez","year":"2008","journal-title":"Acta Cytol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.5468\/OGS.2013.56.1.41","article-title":"Hepatoid carcinoma of the ovary without staining for alpha-fetoprotein","volume":"56","author":"Sung","year":"2013","journal-title":"Obstet Gynecol Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/283295","article-title":"Peritoneal dissemination of hepatoid carcinoma of the ovary treated with cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy","volume":"2013","author":"Cascales Campos","year":"2013","journal-title":"Case Rep Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2017.05.007","article-title":"Metastatic hepatoid carcinoma of ovarian origin - a case report from northern Pakistan [published correction appears in Gynecol Oncol Rep. 2017 Jul 12;22:117. doi: 10.1016\/j.gore.2017.07.004","volume":"21","author":"Mahmood","year":"2017","journal-title":"Gynecol Oncol Rep"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020051","article-title":"Primary hepatoid carcinoma of the ovary: A case report and review of the literature","volume":"99","author":"Choi","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s40944-020-0371-5","article-title":"A rare case of hepatoid carcinoma of the ovary with mini review of literature","volume":"18","author":"Ghosh","year":"2020","journal-title":"Indian J Gynecologic Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S288913","article-title":"Extra-hepatic hepatoid carcinomas in female reproductive system: three case-reports with a literature review","volume":"13","author":"Liu","year":"2021","journal-title":"Cancer Manag Res"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.12892\/ejgo200805556","article-title":"A case of hepatoid carcinoma of the ovary","volume":"29","author":"Ozan","year":"2008","journal-title":"Eur J Gynaecol Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13298","article-title":"Recurrent ovarian undifferentiated carcinoma resembling hepatoid morphology treated with pegylated liposomal doxorubicin and bevacizumab","volume":"43","author":"Ishiguro","year":"2017","journal-title":"J Obstet Gynaecol Res"},{"key":"B25","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1159\/000326479","article-title":"Cytopathologic and clinicopathologic features of ovarian hepatoid carcinoma. A case report","volume":"47","author":"Watanabe","year":"2003","journal-title":"Acta Cytol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.7706","article-title":"SALL4 as an indicator for the diagnosis of hepatoid carcinoma of the ovary: A case report and literature review","volume":"11","author":"Li","year":"2023","journal-title":"Clin Case Rep"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2006.00646.x","article-title":"No ancillary finding is valid to distinguish a primary ovarian hepatoid carcinoma from metastatic hepatocellular carcinoma","volume":"16","author":"Kwon","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"B28","article-title":"Hepatoid carcinoma of the ovary. A case report and review of the literature","volume":"30","author":"Zizi-Sermpetzoglou","year":"2009","journal-title":"Eur J Gynaecol Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.4314\/pamj.v20i1.93","article-title":"Primary hepatoid carcinoma of the ovary: a case report","volume":"20","author":"Mazouz","year":"2015","journal-title":"Pan Afr Med J"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840080536","article-title":"Liver look-alike: Hepatoid ovarian carcinoma","volume":"8","author":"Lefkowitch","year":"1988","journal-title":"Hepatology"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-008-0800-4","article-title":"Alpha-fetoprotein (AFP)-producing ovarian tumor in an elderly woman","volume":"14","author":"Isonishi","year":"2009","journal-title":"Int J Clin Oncol"},{"key":"B32","volume":"45","author":"Tamakoshi","year":"1993","journal-title":"Nihon Sanka Fujinka Gakkai Zasshi"},{"key":"B33","article-title":"Tumeur ovarienne avec diff\u00e9renciation h\u00e9pato\u00efde. Discussion et revue de la litt\u00e9rature. A propos d'une observation [Ovarian tumor with hepatoid differentiation. Discussion and review of the literature. Report of a case","volume":"13","author":"Badreddine","year":"1993","journal-title":"Ann Pathol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1438.1995.05040314.x","article-title":"Ovarian hepatoid carcinoma without staining for alpha-fetoprotein in the primary site","volume":"5","author":"Nishida","year":"1995","journal-title":"Int J Gynecol Cancer"},{"key":"B35","article-title":"Hepatoid carcinoma of the ovary--a case report","volume":"19","author":"Trivedi","year":"1998","journal-title":"Eur J Gynaecol Oncol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.811115.x","article-title":"A hepatoid carcinoma of the ovary","volume":"81","author":"Lee","year":"2002","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.12892\/ejgo200406745","article-title":"Hepatoid carcinoma of the ovary: characteristics of its immunoreactivity. A case report","volume":"25","author":"Tsung","year":"2004","journal-title":"Eur J Gynaecol Oncol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2006.00564.x","article-title":"Hepatoid carcinoma of the ovary: immunohistochemical finding of one case and literature review","volume":"16","author":"Yi\u011fit","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600593117","article-title":"Hepatoid carcinoma of the ovary and management","volume":"86","author":"Lazaro","year":"2007","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.6321","article-title":"Hepatoid carcinoma of the ovary","volume":"29","author":"Pandey","year":"2011","journal-title":"J Clin Oncol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2012.879","article-title":"Hepatoid carcinoma of the ovary: A case report and review of the literature","volume":"4","author":"Liu","year":"2012","journal-title":"Oncol Lett"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-11-29","article-title":"Clinical and pathological features of hepatoid carcinoma of the ovary","volume":"11","author":"Wang","year":"2013","journal-title":"World J Surg Oncol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2015.06.006","article-title":"Hepatoid carcinoma of the ovary: A case report and review of the literature","volume":"13","author":"Randolph","year":"2015","journal-title":"Gynecol Oncol Rep"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2016.08.020","article-title":"A case report of Hepatoid Carcinoma of the Ovary with peritoneal metastases treated with cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy without systemic adjuvant therapy","volume":"27","author":"Naffouje","year":"2016","journal-title":"Int J Surg Case Rep"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2020.100564","article-title":"Hepatoid carcinoma of the ovary - A case report and literature review","volume":"32","author":"Uribe Rivera","year":"2020","journal-title":"Gynecol Oncol Rep"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12072468","article-title":"A rare case of hepatocellular carcinoma recurrence in ovarian site after 12 years mimicking a hepatoid adenocarcinoma: case report","volume":"12","author":"Restaino","year":"2023","journal-title":"J Clin Med"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e3181c7c977","article-title":"Immunohistochemical profile of steroid cell tumor of the ovary: a study of 14 cases and a review of the literature","volume":"29","author":"Jones","year":"2010","journal-title":"Int J Gynecol Pathol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2009.40","article-title":"Glypican-3 expression in clear cell adenocarcinoma of the ovary","volume":"22","author":"Maeda","year":"2009","journal-title":"Mod Pathol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.gynor.2014.03.001","article-title":"Alpha-fetoprotein-producing ovarian clear cell adenocarcinoma simulating fetal gut in a postmenopausal woman","volume":"8","author":"Morimoto","year":"2014","journal-title":"Gynecol Oncol Case Rep"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.04.036","article-title":"Heterogeneity in patients and methods. A problem for hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in ovarian carcinoma","volume":"158","author":"Cascales","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1970223\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:08:17Z","timestamp":1789988897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1970223\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":50,"alternative-id":["10.3389\/fonc.2026.1970223"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1970223","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"1970223"}}