Hepatoid adenocarcinoma (HAC) is rare in the urinary system, with only 7 reported cases in upper urinary tract. This report aimed to explore the genetic characteristics of ureteral HAC for first time, and to describe the treatment prognosis of ureteral HAC.
We present a rare case of ureteral HAC in a 53-year-old female, showing elevated serum levels of AFP and CEA, prolonged chronic irritation may be an important cause of her ureteral HAC. Radical nephroureterectomy was performed, the serum levels of AFP and CEA decreased significantly, and metastasis in lymph nodes was found at 9 months after surgery, she had no related symptoms after 18 months postoperatively without adjuvant chemotherapy. Three driver somatic mutations in cancer were identified by NGS testing, including: TP53D281H, KMT2DL1211Ifs*2, KMT2DT1843Nfs*5, demonstrating that ureteral HAC has the similar mutational features to upper tract urothelial carcinoma. Homologous-recombination deficiency (HRD) was positive in this tumor with no mutations in HRD-related genes, which was possibly induced by the copy number deletion of SETD2 gene.
We report a rare case of ureteral HAC with elevated serum levels of AFP and CEA. NGS testing demonstrated that ureteral HAC has the similar mutational features to upper tract urothelial carcinoma, which is an important guide for the diagnosis and treatment of ureteral HAC.

Intraoral fibrous overgrowths of the soft tissues are relatively common and may be benign reactive or neoplastic lesions. A series of 10 lesions is presented which included pyogenic granuloma, fibroma and peripheral ossifying fibroma. Almost all the lesions occurred in the second and third decades and were present in the anterior segment of the jaws, with a distinct female predilection. Majority of these lesions were asymptomatic and the patients reported for treatment only due to the discomfort during function. Histopathologic examinations were done for diagnosis of these lesions. Surgical excision along with removal of causative irritants remains the treatment of choice. The extent of excision should depend on the severity of the lesion, as some of these lesions have a tendency for recurrence. All the patients in this series were closely followed up for a period of 2 years and showed no signs of recurrence.