Α-fetoprotein producing hepatoid gastric adenocarcinoma with neuroendocrine differentiation: A case report. Issue 37 (September 2018)

• Record Type: Journal Article
• Authors: Li, Tao; Liu, Tongjun; Wang, Min; Zhang, Mingwei
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 97:Issue 37(2018)
• Publication Date: 2018-09
• Subjects: hepatoid gastric adenocarcinoma -- neuroendocrine differentiation -- α-fetoprotein; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000012359
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Hepatoid gastric adenocarcinoma is a rare type of gastric cancer. The phenomenon of neuroendocrine differentiation (NED) in gastrointestinal tumor needs further research. Both hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. However, there is still no specific treatment. Patient Concerns: A 60-year-old man who had a pain and distention in his upper abdomen presented melena. Gastroscopy and pathology revealed a gastric cancer. Diagnoses: Postoperative pathology revealed a hepatoid gastric adenocarcinoma. Immunohistochemical analysis showed a-fetoprotein (AFP), hepatocyte, synaptophysin (Syn), and chromogranin A (CgA) positive, and Ki67 60% positive. A-fetoprotein producing hepatoid gastric adenocarcinoma with NED is diagnosed. Interventions: The patient was treated with an R2 radical gastrectomy, but refused chemotherapy. Outcomes: The AFP level was >2000 ng/mL (0–8.78) half a year after the surgery. There was no obvious abnormality from computed tomography (CT). The patient refused positron emission tomography computed tomography (PET-CT) and left the hospital. Lessons: Hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. It relapses easily. Long-term follow-up and regular examinations are necessary to detect relapses.