Case Report : Hepatoid adenocarcinoma of the stomach: an unusual case of elevated alpha-fetoprotein with prior treatment for hepatocellular carcinoma

• Published in: Clinical and molecular hepatology Vol. 19; no. 2; pp. 173 - 178
• Main Authors: Joon Seong Ahn, Ja Ryong Jeon, Hong Seok Yoo, Taek Kyu Park, Cheol Keun Park, Dong Hyun Sinn, Seung Woon Park
• Format: Journal Article
• Language: Korean
• Published: 대한간학회 25.06.2013
• Subjects: Hepatocellular carcinoma; Hepatoid adenocardinoma; Metachronous; stomach
• ISSN: 2287-2728; 2287-285X

Hepatoid adenocarcinoma (HAC) is a rare type of extrahepatic carcinoma whose morphology is similar to that of hepatocellular carcinoma (Hcc).Metachronous HCC and HAC in the Same patient is extremely rare. The case of a 68-yearold man with chronic hepatitis B infection who had both Hcc and HAC of the stomach is reported herein. Nine years previously this patient had been diagnosed with HCC received a right lobectomy. HCC that recurred at the caudate lobe at 6 months after the operation was successfully treated with transarterial chemoembolization. The patient was followed up regularly thereafter without evidence of tumor recurrence for 9 years. In July 2010 his serum alpha-fetoprotein (AFP) level elevated from 6.5 ng/mL, and he developed a probable single metastatic Iymph node around the hepatic artery without intrahepatic lisions. Subsequent evaluation with upper endoscopy revealed a 4-cm ulcerative lesion on the antrum of the stomach. Subtotal gastrectomy was performed with Iymph-node dissection. Histologic examination revealed a special type of extrahepatic AFP-producing adenocarcinoma-HAC with Iymph-node metastasis-which indicates that HAC can be a cause of elevated AFP even in patients with HCC. HAC should be considered if a patient with stable HCC exhibits unusual elevation of AFP.