Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.15001
Revised: May 7, 2014
Accepted: June 26, 2014
Published online: October 28, 2014
We describe the computed tomography (CT) imaging findings in six cases (five males and one female; age range 61-78 years; mean age 67.3 years) with histologically proven hepatoid adenocarcinoma of the stomach (HAS). Five of the six patients had elevated serum alpha-fetoprotein levels. The most common type of gross appearance HAS on CT is a polypoid mass (83%, 5/6). The most common contrast enhancement pattern was heterogeneous. All six patients had a regional lymphadenopathy larger than 6 mm in its short axis. Liver metastases (n = 3) were noted. Venous tumor thrombosis was identified in the portal vein (n = 2) of the regions near primary gastric tumors or metastatic masses. Our findings suggest in an elderly, male patients with a large heterogeneous enhancement tumor, the presence of distant metastases, regional lymphadenopathy and characteristically increased serum alpha-fetoprotein levels indicates a high likelihood of HAS.
Core tip: Hepatoid adenocarcinoma of the stomach (HAS) has different clinicopathological features and prognosis compared with common stomach cancer without the hepatoid differentiation areas (non-HAS). This case report evaluated the computed tomography (CT) findings of patients with pathologically proved hepatoid adenocarcinoma of the stomach. The results will aid the recognition of HAS and demonstrate that CT is useful in the differentiation of HAS from non-HAS.