Alpha-Fetoprotein-Producing Hepatoid Adenocarcinoma of the Stomach

Lefika Bathobakae, Mohamed Elagami, Anas Mahmoud, Jaydev Kesrani, Ruhin Yuridullah, Gabriel Melki, Amer Akmal, Yana Cavanagh, Walid Baddoura

Abstract


Hepatoid adenocarcinoma of the stomach (HAS) is a rare type of gastric cancer with unique clinicopathological features. HAS has a poor prognosis because of early liver, lung, and lymph node metastasis. Owing to its rarity and malignant potential, data on its pathophysiology and management are scarce. Herein, we describe a case of alpha-fetoprotein-producing HAS (AFP-HAS) with metastases to the liver, lungs, and spine. The patient presented with a 3-month history of epigastric pain and intractable emesis, initially thought to be gastroparesis given her uncontrolled diabetes mellitus. Contrast-enhanced computerized tomography (CECT) of the abdomen and pelvis revealed thickening of the gastric wall with hepatic metastases. Upper endoscopy revealed a fungating gastric mass, and the histopathology confirmed AFP-HAS. The patient did not tolerate palliative chemotherapy and died 6 months after her gastric cancer diagnosis.




J Med Cases. 2024;15(10):304-309
doi: https://doi.org/10.14740/jmc4263

Keywords


Alpha-fetoprotein-producing gastric cancer; Hepatoid adenocarcinoma of the stomach; Abdominal pain; Palliative chemotherapy

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