Case analysis: Imaging findings of gastric hepatoid adenocarcinoma diagnosed with elevated serum alpha-fetoprotein_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

MAI Shengshi ^1,2 , YUAN Fang ¹ ,  YANG Ling ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Radiology, Sanya City People’s Hospital/ West China Sanya Hospital, Sichuan University, Sanya, Hainan 572000 , P. R. China;

Corresponding author：

YANG Ling, Email: florialinda@163.com

Keywords：

hepatoid adenocarcinoma; gastric adenocarcinoma; hepatocellular carcinoma; alpha-fetoprotein; imaging finding

DOI：

10.7507/1007-9424.202406035

Video：

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Abstract Full text Figures/Tables Video References Cited by

Hepatoid adenocarcinoma is a rare extrahepatic malignant tumor with pathological characteristics similar to hepatocellular carcinoma. It is more common in the gastrointestinal tract and patients often have a history of hepatitis and elevated serum alpha fetoprotein (AFP). In clinical practice, patients may seek medical treatment due to liver lesions or elevated AFP, while primary gastrointestinal lesions are easily ignored. The author presents imaging findings of two patients who were diagnosed with hepatoid adenocarcinoma of stomach (HAS) due to elevated AFP in our hospital. By summarizing their clinical imaging characteristics and sorting out various clinical conditions that may cause elevated serum AFP, in order to improve the recognition and differential diagnosis of HAS.

1.	Li M, Mei YX, Wen JH, et al. Hepatoid adenocarcinoma-clinicopathological features and molecular characteristics. Cancer Lett, 2023, 559: 216104. doi: 10.1016/j.canlet.2023.216104.
2.	Xia R, Zhou Y, Wang Y, et al. Hepatoid adenocarcinoma of the stomach: current perspectives and new developments. Front Oncol, 2021, 11: 633916. doi: 10.3389/fonc.2021.633916.
3.	王康韬, 田梦翔, 葛鹤铭, 等. 中国294例胃肝样腺癌临床数据荟萃分析. 中国普通外科杂志, 2022, 31(2): 242-251.
4.	苏伟, 张胜龙, 王文涛, 等. 胃肝样腺癌的 MDT 讨论. 中国普外基础与临床杂志, 2018, 25(2): 213-220.
5.	Søreide JA. Therapeutic approaches to gastric hepatoid adenocarcinoma: current perspectives. Ther Clin Risk Manag, 2019, 23(15): 1469-1477.
6.	Zhang ZR, Wu J, Li HW, et al. Hepatoid adenocarcinoma of the stomach: Thirteen case reports and review of literature. World J Clin Cases, 2020, 8(6): 1164-1171.
7.	Yang Q, Liu Y, Zhang S. Hepatoid adenocarcinoma of the stomach: CT findings. Front Oncol, 2023, 13: 1036763. doi: 10.3389/fonc.2023.1036763.
8.	Lin YY, Chen CM, Huang YH, et al. Liver metastasis from hepatoid adenocarcinoma of the stomach mimicking hepatocellular carcinoma: Dynamic computed tomography findings. World J Gastroenterol, 2015, 21(48): 13524-13531.
9.	Fu Y, Zhu H, Peng WJ. Gastric hepatoid adenocarcinoma: differentiation from gastric adenocarcinoma with dynamic contrast-enhanced computed tomographic findings. J Comput Assist Tomogr, 2019, 43(6): 887-891.
10.	俞程彬, 马贵亮, 毛伟征. 胃肝样腺癌的诊治现状. 中国普外基础与临床杂志, 2020, 27(4): 515-520.
11.	Liang P, Wang YX, Ren XC, et al. Neuroendocrine carcinoma of the stomach: clinical features and CT findings. Abdom Radiol (NY), 2016, 41(1): 19-24.
12.	高歌, 梁盼, 王睿, 等. CT鉴别诊断胃神经内分泌癌与胃腺癌. 中国介入影像与治疗学, 2021, 18(8): 465-469.
13.	严志强, 贺文广, 瞿华, 等. 胃肝样腺癌CT影像特征及误诊分析. 浙江中西医结合杂志, 2020, 30(3): 235-237.
14.	Chang MY, Kim HJ, Park SH, et al. CT features of hepatic metastases from hepatoid adenocarcinoma. Abdom Radiol (NY), 2017, 42(10): 2402-2409.
15.	Hanif H, Ali MJ, Susheela AT, et al. Update on the applications and limitations of alpha-fetoprotein for hepatocellular carcinoma. World J Gastroenterol, 2022, 28(2): 216-229.
16.	Adigun OO, Yarrarapu SNS, Zubair M, et al. Alpha-Fetoprotein Analysis. [Updated 2024 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430750/.
17.	郑岚, 刘晓黎, 曹立. 共济失调毛细血管扩张症四例临床表型及基因突变分析. 中国现代神经疾病杂志, 2017, 17(7): 519-525.

1. Li M, Mei YX, Wen JH, et al. Hepatoid adenocarcinoma-clinicopathological features and molecular characteristics. Cancer Lett, 2023, 559: 216104. doi: 10.1016/j.canlet.2023.216104.
2. Xia R, Zhou Y, Wang Y, et al. Hepatoid adenocarcinoma of the stomach: current perspectives and new developments. Front Oncol, 2021, 11: 633916. doi: 10.3389/fonc.2021.633916.
3. 王康韬, 田梦翔, 葛鹤铭, 等. 中国294例胃肝样腺癌临床数据荟萃分析. 中国普通外科杂志, 2022, 31(2): 242-251.
4. 苏伟, 张胜龙, 王文涛, 等. 胃肝样腺癌的 MDT 讨论. 中国普外基础与临床杂志, 2018, 25(2): 213-220.
5. Søreide JA. Therapeutic approaches to gastric hepatoid adenocarcinoma: current perspectives. Ther Clin Risk Manag, 2019, 23(15): 1469-1477.
6. Zhang ZR, Wu J, Li HW, et al. Hepatoid adenocarcinoma of the stomach: Thirteen case reports and review of literature. World J Clin Cases, 2020, 8(6): 1164-1171.
7. Yang Q, Liu Y, Zhang S. Hepatoid adenocarcinoma of the stomach: CT findings. Front Oncol, 2023, 13: 1036763. doi: 10.3389/fonc.2023.1036763.
8. Lin YY, Chen CM, Huang YH, et al. Liver metastasis from hepatoid adenocarcinoma of the stomach mimicking hepatocellular carcinoma: Dynamic computed tomography findings. World J Gastroenterol, 2015, 21(48): 13524-13531.
9. Fu Y, Zhu H, Peng WJ. Gastric hepatoid adenocarcinoma: differentiation from gastric adenocarcinoma with dynamic contrast-enhanced computed tomographic findings. J Comput Assist Tomogr, 2019, 43(6): 887-891.
10. 俞程彬, 马贵亮, 毛伟征. 胃肝样腺癌的诊治现状. 中国普外基础与临床杂志, 2020, 27(4): 515-520.
11. Liang P, Wang YX, Ren XC, et al. Neuroendocrine carcinoma of the stomach: clinical features and CT findings. Abdom Radiol (NY), 2016, 41(1): 19-24.
12. 高歌, 梁盼, 王睿, 等. CT鉴别诊断胃神经内分泌癌与胃腺癌. 中国介入影像与治疗学, 2021, 18(8): 465-469.
13. 严志强, 贺文广, 瞿华, 等. 胃肝样腺癌CT影像特征及误诊分析. 浙江中西医结合杂志, 2020, 30(3): 235-237.
14. Chang MY, Kim HJ, Park SH, et al. CT features of hepatic metastases from hepatoid adenocarcinoma. Abdom Radiol (NY), 2017, 42(10): 2402-2409.
15. Hanif H, Ali MJ, Susheela AT, et al. Update on the applications and limitations of alpha-fetoprotein for hepatocellular carcinoma. World J Gastroenterol, 2022, 28(2): 216-229.
16. Adigun OO, Yarrarapu SNS, Zubair M, et al. Alpha-Fetoprotein Analysis. [Updated 2024 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430750/.
17. 郑岚, 刘晓黎, 曹立. 共济失调毛细血管扩张症四例临床表型及基因突变分析. 中国现代神经疾病杂志, 2017, 17(7): 519-525.

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