title: Hepatoid adenocarcinoma of the stomach--proper identification and treatment remain a challenge.
abstract: OBJECTIVE
  The term hepatoid adenocarcinoma (HAC) of the stomach was introduced three decades ago with the observation of high serum α-fetoprotein (AFP) levels in some gastric adenocarcinoma patients. This very rare gastric cancer patient subgroup is likely frequently misdiagnosed.
  
  
  METHODS
  Two patients who were recently diagnosed with HAC of the stomach at our institution are presented. We also performed a structured literature search and reviewed pertinent articles to provide knowledge to improve the proper identification, diagnosis and management of patients with gastric HAC.
  
  
  RESULTS
  HAC is a rare subgroup of gastric carcinoma with poor prognosis. Clinical management of this population may be challenging. The scientific literature is largely based on very small patient series or case reports, and the evidence for proper decision making and management is considered weak.
  
  
  CONCLUSIONS
  All physicians involved in the diagnosis and treatment of patients with gastric cancer should pay attention to this rare subgroup to improve identification.
authors.affiliation: a Department of Gastrointestinal Surgery , Stavanger University Hospital , Stavanger , Norway ;|b Department of Clinical Medicine , University of Bergen , Bergen , Norway ;
authors.forename: Jon Arne
authors.initials: JA
authors.lastname: Søreide
authors.affiliation: c Department of Radiology , Stavanger University Hospital , Stavanger , Norway ;
authors.forename: Ole Jacob
authors.initials: OJ
authors.lastname: Greve
authors.affiliation: d Department of Pathology , Stavanger University Hospital , Stavanger , Norway ;
authors.forename: Einar
authors.initials: E
authors.lastname: Gudlaugsson
authors.affiliation: e Department of Gastroenterology , Stavanger University Hospital , Stavanger , Norway.
authors.forename: Svein
authors.initials: S
authors.lastname: Størset
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery
keywords: Alpha-fetoprotein; gastric; hepatoid adenocarcinoma; prognosis; stomach