Hepatoid adenocarcinoma of the stomach: a case report.
A patient with primary gastric carcinoma showing a high level of serum a-fetoprotein (AFP) (368 ng/ml) is described. Subtotal gastrectomy was performed, and a month after surgery the level of serum AFP fell rapidly to within normal limits. Histologically, two types of cells coexisted in the tumor: medullary-type cells resembling trabecular-type hepatocellular carcinoma, and moderately differentiated adenocarcinoma cells. The cells of the former type were arranged mostly in a trabecular pattern with bile granules, but also showed a scirrhous pattern in a restricted area. Immunohistochemistry demonstrated that both types of tumor cells stained positively for AFP. This tumor, which should be classified as a hepatoid adenocarcinoma of the stomach, is of interest because of its rarity, bile secretion (indicating marked differentiation toward a hepatocyte form), and two cellular arrangements-trabecular and scirrhous.
Sugawara
Y
Y
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Konishi
T
T
Hiraishi
M
M
Sato
A
A
Natomi
H
H
Aoki
T
T
Makuuchi
M
M
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins