Gastric hepatoid adenocarcinoma with multiple liver metastasis: a case report
Gastroenterology and Hepatology from Bed to Bench,
26 April 2021
Hepatoid adenocarcinoma is a poorly differentiated alpha-fetoprotein-producing (AFP) tumor frequently located in the stomach, ovary, and pancreas. Presentation in the stomach has a high mortality rate due to late diagnosis, which offers the patient few therapeutic alternatives. On February 22, 2019, a 44-year-old woman from Lima entered the emergency department for pain in the right hypochondrium for 4 months, weight loss, nausea, and asthenia. On physical examination, hepatomegaly presented with a liver spam of 17 cm. Serology showed severe anemia and AFP of 49,800. The tomography showed multiple hypodense lesions in the liver and the presence of nodes. Endoscopy showed Bormann III gastric malignancy. Gastric biopsy determined undifferentiated epithelial malignancy; the immunohistochemical mark (+) for AFP and PAS Diastase confirmed a hepatoid gastric adenocarcinoma. A rare variant of gastric adenocarcinoma was evident, which often mimics an HCC. In this case, multiple liver metastases were observed that differed from the diagnosis of HCC, so this variant must always be taken into account when a primary gastric tumor presents with hepatic metastases.
Keywords: Hepatoid adenocarcinoma, Metastases, Liver.
(Please cite as: Quino-Florentini M, Garcia-Rojas F, Guerra-Canchari P, Cerrillo-Sanchez G. Gastric hepatoid adenocarcinoma with multiple liver metastasis: a case report. Gastroenterol Hepatol Bed Bench 2021;14(3):281-285).
- Hepatoid Adenocarcinoma, metastases, liver
Wang Y, Sun L, Li Z, Gao J, Ge S, Zhang C, et al. Hepatoid adenocarcinoma of the stomach: a unique subgroup with distinct clinicopathological and molecular features. Gastric Cancer 2019;1-10.
Li T, Liu T, Wang M, Zhang M. Α-fetoprotein producing hepatoid gastric adenocarcinoma with neuroendocrine differentiation: A case report. Medicine 2018;97.
Qu BG, Bi WM, Qu BT, Qu T, Han XH, Wang H, et al. PRISMA-Compliant Article: Clinical Characteristics and Factors Influencing Prognosis of Patients With Hepatoid Adenocarcinoma of the Stomach in China. Medicine 2016;95:e3399.
Zhang ZR, Wu J, Li HW, Wang T. Hepatoid adenocarcinoma of the stomach: Thirteen case reports and review of literature. World J Clin Cases 2020;8:1164-71.
Lakshmanan A, Kurian A, Subramanyan A, Srinivasan, A. An alpha fetoprotein producing gastric tumor with yolk sac, hepatoid and papillary adenocarcinoma components. J Clin Diagnostic Res 2017;11:ED03.
Kuroda N, Yorita K. Clinicopathologic study of 10 cases of gastric adenocarcinoma with hepatoid or enteroblastic differentiation. Polish J Pathol 2018;69:128-35.
Haninger DM, Kloecker GH, Bousamra Ii M, Nowacki MR, Slone SP. Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature. Mod Pathol 2014;27:535-42.
Chen X, Li A, Wang Q, Shen Y, Li Z, Peng J, et al. Hepatoid adenocarcinoma in the peritoneal cavity. Medicine 2019;98.
Zeng XY, Yin YP, Xiao H, Zhang P, He J, Liu WZ, et al. Clinicopathological Characteristics and Prognosis of Hepatoid Adenocarcinoma of the Stomach: Evaluation of a Pooled Case Series. Curr Med Sci 2018;38:1054-61.
Terracciano LM, Glatz K, Mhawech P, Vasei M, Lehmann FS, Vecchione R, et al. Hepatoid adenocarcinoma with liver metastasis mimicking hepatocellular carcinoma: an immunohistochemical and molecular study of eight cases. Am J Surg Pathol 2003;27:1302‐1312.
Simmet V, Noblecourt M, Lizée T, Morvant B, Girault S, Soulié P, et al. Chemotherapy of metastatic hepatoid adenocarcinoma: Literature review and two case reports with cisplatin etoposide. Oncol Lett 2018;15:48‐54.
Fakhruddin N, Bahmad HF, Aridi T, Yammine Y, Mahfouz R, Boulos F, et al. Hepatoid Adenocarcinoma of the Stomach: A Challenging Diagnostic and Therapeutic Disease through a Case Report and Review of the Literature. Front Med 2017;4:164.
Zhao M, Sun L, Lai JZ, Shi H, Mei K, He X, et al. 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. Pathol-Res Prac 2018;214:1707-12.
Takii Y, Mitsugi K, Kimura K, Mihara Y. The Effectiveness of Hepatic Arterial Infusion Chemotherapy with 5-Fluorouracil/Cisplatin and Systemic Chemotherapy with Ramucirumab in Alpha-Fetoprotein-Producing Gastric Cancer with Multiple Liver Metastases. Case Rep Oncol Med 2018;2018:5402313.
- Abstract Viewed: 0 times
- PDF Downloaded: 0 times