title: α-Fetoprotein-Producing Hepatoid Gastric Adenocarcinoma With Osteoclast-Like Giant Cells and Neuroendocrine Differentiation: A Case Study With Molecular Profiling.
abstract: Here we present the case of a 73-year-old woman with an ulcerated, advanced, hepatoid, and α-fetoprotein-producing poorly differentiated (G3) primary gastric adenocarcinoma pT3 N3a M1 with multinucleated cells and evident neuroendocrine component. This tumor was consistent with giant cell tumor type gastric carcinoma with osteoclast-like giant cells (OGCs). The cancer was HER2 and E-cadherin negative, chromogranin A dispersedly and moderately positive, and strongly α-fetoprotein-positive with evident CK AE1/AE3 immunoreactivity, while OGCs expressed CD68. To provide an insight into the molecular background of this peculiar neoplasm, next-generation sequencing (NGS) was performed to analyze the 50 most frequently mutated oncogenes and tumor suppressors. We detected mutations in the primary tumor in the following genes: KIT, EGFR, PTEN, ATM, and RB1. In the liver metastasis, we revealed mutations in 3 genes: PIK3CA, KIT, and CDKN2A.
authors.affiliation: Department of Anatomy, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland Non Public Health Care Unit - Department of Pathology, Kielce, Poland, Specialist Medical Practice-Pathologist Kielce ruahpolin@yahoo.com.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wincewicz
authors.affiliation: Department of Molecular Diagnostics, Holy Cross Cancer Center, Kielce, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Kowalik
authors.affiliation: Department of Molecular Diagnostics, Holy Cross Cancer Center, Kielce, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zięba
authors.affiliation: Non Public Health Care Unit - Department of Pathology, Kielce, Poland, Specialist Medical Practice-Pathologist Kielce Department of Pathology, Faculty of Health Sciences, Jan Kochanowski University of Kielce.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lewitowicz
authors.affiliation: Department of Clinical Oncology Holy Cross Cancer Centre, Kielce, Poland Department of Prevention and Epidemiology of Neoplasms, Institute of Public Health, Faculty of Health Sciences, Jan Kochanowski University, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Góźdź
authors.affiliation: Department of General Pathomorphology, Collegium Pathologicum, Medical University of Bialystok, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Sulkowski
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D015726:Giant Cells / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D010010:Osteoclasts / Q000378:metabolism / Q000473:pathology; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology; D000509:alpha-Fetoproteins / Q000378:metabolism*; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; C067980:CD68 antigen, human; D000097382:CD68 Molecule
keywords: gastric cancer; immunoprofiling; molecular profiling; osteoclast-like giant cells (OGCs)