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Background: Gastric cancer is the third most common cause of cancerrelated death worldwide. Alpha-fetoprotein producing gastric cancer (AFP-GC) is a subtype of gastric cancer which has more aggressive behavior than the common type. Awareness and understanding of this disease entity are of paramount importance, because treatment is different from that of the classical gastric cancer. Method: The literature search started from 1970, when the first patient of AFP-GC was reported, until March of 2017, using Google search engine, PUB Med to identify relevant articles on alpha-fetoprotein producing gastric cancer. Subsequent references searches were done from the retrieved articles. Results: Since the first case of alpha-fetoprotein producing gastric cancer was first reported, many cases have been reported, mostly in Asia. Although AFP-GCs have been recognized in Japan and parts of Asia for more than 40 years, there were only a few publications about AFP-GC outside of Asia. In this article, I review literature concerning the clinicopathological features, immunoreactivity, molecular biology, treatment, and prognosis of AFP-GC. Conclusion: In the literature, some potential protein markers were identified, and cellular pathways involved in AFP-GCs were suggested. Two types of targeted drugs have been used to treat such patients with a good response. Further studies of the roles of these markers and pathways may shed light on developing more effective drugs to treat patients with AFP-GC.

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