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Hepatoid adenocarcinoma of the stomach: Nine case reports and treatment outcomes
Cheng Xiao1, Fusheng Wu1, Han Jiang1
1Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310003, P.R. China.
Insights
Hepatoid adenocarcinoma of the stomach (GHAC) is rare and aggressive. Early diagnosis and multimodality treatment, including surgery and chemotherapy, are crucial for better patient outcomes.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Hepatoid adenocarcinoma (HAC) presents morphological similarities to hepatocellular carcinoma.
- Gastric hepatoid adenocarcinoma (GHAC) is a rare gastric cancer variant with aggressive behavior and poor prognosis.
- Accurate diagnosis relies on clinicopathological and immunohistochemical evaluation.
Purpose of the Study:
- To report on nine cases of gastric hepatoid adenocarcinoma (GHAC).
- To analyze treatment strategies and outcomes for GHAC patients.
- To highlight the importance of early diagnosis and multimodality treatment for GHAC.
Main Methods:
- Retrospective analysis of nine GHAC cases treated between January 2009 and December 2013.
- All patients underwent radical gastrectomy.
- Clinicopathological data, including staging and serum α-fetoprotein levels, were reviewed.
Main Results:
- Eight out of nine patients showed elevated serum α-fetoprotein.
- Seven patients were diagnosed with Stage III disease.
- Outcomes included one death, four liver metastases, one lung metastasis, and four disease-free patients.
Conclusions:
- Gastric hepatoid adenocarcinoma (GHAC) necessitates accurate early diagnosis.
- Radical gastrectomy combined with adjuvant chemotherapy may improve survival.
- Multimodality treatment is essential for managing this aggressive gastric cancer variant.
Abstract:
Hepatoid adenocarcinoma (HAC), an extrahepatic tumor, has notable morphological similarities to hepatocellular carcinoma, which has been reported in gastrointestinal tract organs, including the rectum, gallbladder, lung, ovary and urinary bladder. HAC of the stomach (GHAC) is a rare variant of gastric cancer, characterized by aggressive behavior and extremely poor prognosis. Correct diagnosis depends on clinicopathological and immunohistochemical studies. In the present study, we reported nine cases of GHAC who were treated in the First Affiliated Hospital of Zhejiang University, China, from January 2009 to December 2013. All patients underwent radical gastrectomy; among them, one patient had stage I, one had stage II and seven had stage III. Elevated serum α-fetoprotein was observed in eight cases. Until now, only one patient has succumbed, four patients have liver metastases, one has lung metastasis and four remain disease-free. Relatively longer survival requires accurate diagnosis at an earlier stage and active multimodality treatment, including radical gastrectomy and adjuvant chemotherapy.
