Hepatoid Adenocarcinoma of the Stomach: Current Perspectives and New Developments

Abstract

Hepatoid adenocarcinoma of the stomach (HAS) is a rare malignant tumor, accounting for only 0.17–15% of gastric cancers. Patients are often diagnosed at an advanced disease stage, and their symptoms are similar to conventional gastric cancer (CGC) without specific clinical manifestation. Morphologically, HAC has identical morphology and immunophenotype compared to hepatocellular carcinoma (HCC). This is considered to be an underestimation in diagnosis due to its rare incidence, and no consensus is reached regarding therapy. HAS generally presents with more aggressive behavior and worse prognosis than CGC. The present review summarizes the current literature and relevant knowledge to elaborate on the epidemic, potential mechanisms, clinical manifestations, diagnosis, management, and prognosis to help clinicians accurately diagnose and treat this malignant tumor.

Prognostic Analysis of Gastric Signet Ring Cell Carcinoma and Hepatoid Adenocarcinoma of the Stomach: A Propensity Score-Matched Study

“…HAS is a rare neoplasm, and the annual incidence of HAS is approximately 0.58-0.83 cases per million people (6,15). Previous studies were mainly case reports or case series from a single medical center and mainly came from Asian regions (1,2,16). In these previous studies, HAS patients often were reported to have a worse prognosis than non-HAS patients (17,18).…”

“…Hepatoid adenocarcinoma of the stomach (HAS) is a rare type of primary gastric cancer (GC), and most previous studies have reported that the incidence of HAS is less than 1% of all GC ( 1 , 2 ). According to the World Health Organization (WHO) gastrointestinal tumor sample classification, hepatoid adenocarcinoma (HAC) is defined as adenocarcinoma of extrahepatic origin with morphological features of liver cell differentiation, composed of large polygonal eosinophilic hepatocytes such as neoplastic cells ( 3 ).…”

Computed Tomography Features and Clinical Prognostic Characteristics of Hepatoid Adenocarcinoma of the Stomach

“…Hepatoid adenocarcinoma (HAC) is a clinically rare and specific type of malignancy that occurs in tissues and organs other than the liver (1). Histologically, the tumor cells of HAC are polygonal and proliferate in a solid or trabecular fashion, showing many hepatocellular carcinoma (HCC)-like features such as intracytoplasmic glycogen granules, centripetal annular lamellar vesicles, and proliferation in capillary bile ducts (2)(3)(4).…”

“…Histologically, the tumor cells of HAC are polygonal and proliferate in a solid or trabecular fashion, showing many hepatocellular carcinoma (HCC)-like features such as intracytoplasmic glycogen granules, centripetal annular lamellar vesicles, and proliferation in capillary bile ducts (2)(3)(4). HAC can occur in the stomach, esophagus, duodenum, jejunum, colon, peritoneum, pancreas, lungs, ovaries, gallbladder, and uterus, with the stomach being the most common site of occurrence (1,2). Hepatoid adenocarcinoma of the stomach (HAS) was first proposed in 1985 by Ishikura et al (5).…”

“…Hepatoid adenocarcinoma of the stomach (HAS) was first proposed in 1985 by Ishikura et al (5). It accounts for approximately 0.17%-15% of all gastric cancers, with an estimated annual incidence of 0.58-0.83 cases per 1 million individuals (6)(7)(8)(9), and shows atypical clinical symptoms that are characterized by high serum AFP (1). Previous reports focused on pathologic and clinical manifestations, and only a few reports involving a small number of cases have reported the computed tomography (CT) findings of HAS (10)(11)(12).…”