Hepatoid carcinoma of the stomach

A patient with primary gastric carcinoma exhibiting hepatoid differentiation is described. The tumor itself was not associated with a high serum alpha-fetoprotein, but the cells stained positive for alpha-fetoprotein and alpha-1 antitrypsin. The patient underwent a total gastrectomy and wedge excision of the liver metastasis. The presence of metastatic hepatoid adenocarcinoma of the stomach should be considered in a patient who, during surgery for a primary gastric carcinoma, is found to have a liver metastasis that is diagnosed by frozen-section biopsy as a hepatoma. Because of lymph node and liver metastasis, prognosis appears to be poor for such patients.