Hepatoid adenocarcinoma of the stomach with neuroendocrine differentiation: A case report and review of literature

Table 1 Reported cases of gastric cancer including hepatoid adenocarcinoma and neuroendocrine components

Ref.	Rassidakis et al[60]	Okamoto et al[61]	Suzuki et al[62]	Lipi et al[63]	Wincewicz et al[64]	Li et al[65]	Current case
Age	48	78	83	50	73	60	61
Sex	Man	Woman	Man	Man	Woman	Man	Man
TNM stage	N3	T3N2M0	T4N2M1	N3	T3N3M1	T2N1Mx	T3N2M0
Tumor location	Anterior wall of the gastric body	Pyloric antrum	Upper-third of the stomach	Cardia		Gastric antrum	Gastric antrum
Tumor size	70 mm × 55 mm	90 mm × 60 mm × 30 mm	75 mm × 110 mm	85 mm × 65 mm × 45 mm	60 mm × 40 mm	16 mm	20 mm × 15 mm × 5 mm
Histologic patterns	HAC, NED	HAC, NEC, TAC	HAC, NEC, TAC	HAC, LCNEC, TAC	HAC, NED, OGCs	HAC, NED	HAC, NED
Immunohistochemistry	CGA, AFP	CK8, AE1/AE3, AFP, CGA	CGA, AFP, SP	AFP, Syn, CGA, CK	CGA, AFP, AE1/AE3, CK	AFP, Syn, CGA	SALL4, AFP, GPC-3, Syn, CgA
Surgery	Total gastrectomy	Subtotal gastrectomy with lymphadenectomy	Gastrectomy	Total gastrectomy		R2 radical gastrectomy	Distal gastrectomy with D2 lymphadenectomy
Treatment	Doxorubicin, mitomycin-C, 5-fluorouracil, octreotide (4 cycles)			Cisplatin + VP 16 (2 cycles)			Docetaxel + oxaliplatin + capecitabine (10 cycles), irinotecan + S-1 + apatinib (3 cycles)
AFP, ng/mL	800 (post-op)	168 (pre-op)				1683 (pre-op)
Outcome	Alive, 12 mo	Died, 53 mo, liver recurrence	Died, 6 mo		Liver recurrence	Alive, 6 mo	Died, 27 mo, liver recurrence

GC: Gastric cancer; HAC: Hepatoid adenocarcinoma; NEC: Neuroendocrine carcinoma; NED: Neuroendocrine differentiation; TAC: Tubular adenocarcinoma; OGCs: Osteoclast-like giant cells; AFP: Alpha-fetoprotein; CGA: Chromogranin A; Syn: Synaptophysin; CK: Cytokeratin; pre-op: Preoperatively; post-op: Postoperatively; LCNEC: Large-cell NEC.