Augustin G, Jelincic Z, Tentor D, Majerovic M, Matosevic P
Department of Surgery, Division of Abdominal Surgery, Clinical Hospital Center Zagreb, Croatia.
Acta Gastroenterol Belg. 2009 Apr-Jun;72(2):253-6.
Hepatoid adenocarcinoma of the stomach is a rare type of gastric carcinoma with an extremely poor prognosis. We describe a 72-year-old man who underwent esophagogastroduodenoscopy which revealed 50 mm exulcerated lesion with a central necrosis on the lesser curvature and the posterior wall of the body of the stomach. Gastric biopsy revealed a poorly differentiated (anaplastic) adenocarcinoma. The serum level of alpha-fetoprotein (AFP) was (3220 ng/mL). After diagnosis of AFP-producing gastric adenocarcinoma, total gastrectomy, with splenectomy, was performed. The tumor showed immunohistochemical positivity for AFP and Hep Par 1. According to these histopathological and immunohistochemical findings, the tumor was diagnosed as hepatoid adenocarcinoma. At 24 months postoperatively the patient is still alive without metastatic disease on repeated abdominal CTs. Because of the poor prognosis for this histological type of tumor, accurate diagnosis of hepatoid adenocarcinoma is important, and long-term follow-up is required.
胃肝样腺癌是一种罕见的胃癌类型，预后极差。我们描述了一名72岁男性，他接受了食管胃十二指肠镜检查，发现胃体小弯侧和后壁有一个50毫米的溃疡性病变，中央有坏死。胃活检显示为低分化（间变性）腺癌。血清甲胎蛋白（AFP）水平为（3220纳克/毫升）。在诊断为产生AFP的胃腺癌后，进行了全胃切除术并切除脾脏。肿瘤对AFP和Hep Par 1免疫组化呈阳性。根据这些组织病理学和免疫组化结果，该肿瘤被诊断为肝样腺癌。术后24个月，患者仍存活，多次腹部CT检查未发现转移疾病。由于这种组织学类型的肿瘤预后较差，准确诊断肝样腺癌很重要，并且需要长期随访。
