Hepatoid adenocarcinoma of the stomach: report of five cases and review of the literature

We report on a rare hepatoid adenocarcinoma of the stomach producing alpha-fetoprotein (AFP) in five cases. Definitive features included an aggressive, invasive, and rapidly progressing neoplasm showing areas morphologically comparable to those of hepatocellular carcinomas. All patients had multiple metastases to lymph nodes and/or liver. The serum AFP level of the patients was between 83-87.900 ng/ml. Two subtotal and one palliative gastrectomy was performed. A short duration of chemotherapy was administered only in two patients. The length of survival averaged 4.7 months. Our experience together with what has been reported in literature suggest that the course of hepatoid adenocarcinoma of the stomach is more aggressive than an ordinary adenocarcinoma and that from a diagnostic point of view distinction from an adenocarcinoma may be accomplished histochemically and by measuring serum AFP levels.