Korean J Med.  2007 Jul;73(1):107-111.

A case of gastric hepatoid adenocarcinoma misdiagnosed as an extragonadal germ cell tumor

Affiliations
  • 1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. ijchung@chonnam.ac.kr

Abstract

Hepatoid adenocarcinoma is a rare variant of adenocarcinoma that can occur in the stomach. This neoplasm has a poor prognosis and it frequently presents at an advanced stage of disease; it is clinically characterized by increased serum levels of alpha-fetoprotein (AFP) in most cases. We experienced a case of hepatoid adenocarcinoma of the stomach with multiple liver metastases that mimicked germ cell tumor in a 43-year-old man. He had incidentally detected gastric adenocarcinoma via gastrofibroscopy and he underwent subtotal gastrectomy. The postoperative pathologic stage was II (T2N1M0). He complained of epigastric pain. The serum AFP was markedly increased (227,325 IU/mL) and abdominal CT revealed multiple liver masses. We considered these as extragonadal germ cell tumors that occurred in the liver because of the markedly elevated AFP, the short duration of follow-up and early stage of stomach cancer at the that time. To confirm the diagnosis, biopsy of liver mass was done and he was diagnosed with hepatoid adenocarcinoma.

Keyword

Gastric cancer; Alpha-fetoproteins

MeSH Terms

Adenocarcinoma*
Adult
alpha-Fetoproteins
Biopsy
Diagnosis
Follow-Up Studies
Gastrectomy
Germ Cells*
Humans
Liver
Neoplasm Metastasis
Neoplasms, Germ Cell and Embryonal*
Prognosis
Stomach
Stomach Neoplasms
Tomography, X-Ray Computed
alpha-Fetoproteins
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