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Case Report

Highlighting the Importance of Signaling Pathways and Immunohistochemistry Features in HCC: A Case Report and Literature Review

by
Madalin Alexandru Hasan
,
Ioana Larisa Paul
,
Simona Cavalu
*,
Ovidiu Laurean Pop
,
Lorena Paduraru
,
Ioan Magyar
and
Mihaela Doina Chirila
Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 Decembrie 10, 410087 Oradea, Romania
*
Author to whom correspondence should be addressed.
Reports 2025, 8(4), 197; https://doi.org/10.3390/reports8040197
Submission received: 31 July 2025 / Revised: 28 September 2025 / Accepted: 30 September 2025 / Published: 3 October 2025
(This article belongs to the Section Oncology)
Versions Notes

Abstract

Background and Clinical Significance: In hepatocellular carcinoma (HCC), numerous signaling pathways become aberrantly regulated, resulting in sustained cellular proliferation and enhanced metastatic potential. Tumors that lack PYGO2 may not show the same types of tissue remodeling or regenerative features driven by the Wnt/β-catenin pathway, which could make the tumor behave differently from others that are Wnt-positive. PIK3CA-positive tumors are often associated with worse prognosis due to the aggressive nature of the PI3K/AKT pathway activation. This is linked to higher chances of metastasis, recurrence, and resistance to therapies that do not target this pathway. Case presentation: In this paper we present a rare case of hepatocellular carcinoma with PIK3CA-positive and PYGO2-negative signaling pathways, several key aspects of the tumor’s behavior, prognosis, and treatment options. Although alpha-fetoprotein (AFP) levels were significantly elevated, the CT and MRI examination showed characteristics of malignancy, HCC with secondary hepatic lesions and associated perfusion disturbances. The case particularities and immunohistochemistry features are highlighted in the context of literature review, the PIK3CA mutation suggesting the activation of the PI3K/AKT/mTOR pathway, a critical signaling pathway involved in cell survival, proliferation, and metabolism. Conclusions: Due to the aggressive nature of PIK3CA mutations, close monitoring and consideration of immunotherapy and targeted treatments are of crucial importance.
Keywords: hepatocellular carcinoma; PYGO2; PIK3CA; hTERT; MAPK hepatocellular carcinoma; PYGO2; PIK3CA; hTERT; MAPK

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MDPI and ACS Style

Hasan, M.A.; Paul, I.L.; Cavalu, S.; Pop, O.L.; Paduraru, L.; Magyar, I.; Chirila, M.D. Highlighting the Importance of Signaling Pathways and Immunohistochemistry Features in HCC: A Case Report and Literature Review. Reports 2025, 8, 197. https://doi.org/10.3390/reports8040197

AMA Style

Hasan MA, Paul IL, Cavalu S, Pop OL, Paduraru L, Magyar I, Chirila MD. Highlighting the Importance of Signaling Pathways and Immunohistochemistry Features in HCC: A Case Report and Literature Review. Reports. 2025; 8(4):197. https://doi.org/10.3390/reports8040197

Chicago/Turabian Style

Hasan, Madalin Alexandru, Ioana Larisa Paul, Simona Cavalu, Ovidiu Laurean Pop, Lorena Paduraru, Ioan Magyar, and Mihaela Doina Chirila. 2025. "Highlighting the Importance of Signaling Pathways and Immunohistochemistry Features in HCC: A Case Report and Literature Review" Reports 8, no. 4: 197. https://doi.org/10.3390/reports8040197

APA Style

Hasan, M. A., Paul, I. L., Cavalu, S., Pop, O. L., Paduraru, L., Magyar, I., & Chirila, M. D. (2025). Highlighting the Importance of Signaling Pathways and Immunohistochemistry Features in HCC: A Case Report and Literature Review. Reports, 8(4), 197. https://doi.org/10.3390/reports8040197

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