Abstract. Hepatoid adenocarcinoma (HAC) is a rare form of gastric cancer that has unique clinicopathological features and an extremely poor prognosis. The present case report describes a patient who was referred to the No. 461 Hospital of PLA (Changchun, China) due to nausea and occasional vomiting of acid/water. The patient was diagnosed with gastric signet-ring cell carcinoma and surgery was recommended. A total gastrectomy was performed on the operable lesion. Histopathological analysis revealed that the tumors exhibited two pathological changes: HAC and signet-ring cell carcinoma differentiation. Furthermore, the tumor cells were immunohistochemically positive for α-fetoprotein, cytokeratin low/high molecular weight, Cam5.2, cytokeratin 7, p53, epithelial membrane antigen and carcinoembryonic antigen. Previous studies and our experience have suggested that HAC is an aggressive type of adenocarcinoma; however, radical surgery and chemotherapy may positively impact clinical outcomes.