ABSTRACT
Objective:To review the clinicopathological characteristics and analyze the prognostic factors of hepatoid adenocarcinoma of stomach(HAS).Methods:From August 2012 to June 2017,30 patients with HAS were diagnosed in Daycare of Peking University Cancer Hospital.Clinicopathological data and follow-up information of these patients were retrospectively collected and analyzed.Re-sults:The median age of these 30 patients was 58 years at diagnosis,with a male-to-female ratio of 2.75:1.Twenty-nine patients were confirmed to have lymph node metastases and 7 patients had distant metastases.Ten patients died because of the cancer within the follow-up period.The 1-and 3-year survival rates were 60% and 52%,respectively.Cox multivariate regression revealed that elevated serum CA199 levels,higher lymph node staging,not having undergone radical surgery,and stronger immunohistochemical(IHC)stain-ing intensity of alpha fetoprotein(AFP)were independent poor prognostic factors.Conclusions:Elevated serum CA199 levels,lymph node staging,and IHC staining intensity of AFP are verified in this study as independent risk factors of poor outcome in HAS patients. Early detection and diagnosis of the disease may improve the clinical prognosis.Multidisciplinary team discussions are important in making therapy decisions and radical surgery should be performed whenever possible.
ABSTRACT
Gastrointestinal stromal tumours (GIST) are rare mesenchymal neoplasms in the gastrointestinal tract. The metachronous existence of GIST and gastric adenocarcinoma, though are tumours of distinct histotype, and very rare, have been reported in medical case reports in recent years. We report a case of a 74 year old man who initially presented with moderately differentiated adenocarcinoma of the stomach, underwent Billroth 2 gastrectomy followed by chemotherapy. Subsequently, after 15 months he developed a GIST of small bowel with metastasis from adenocarcinoma of stomach. Taking into consideration the fact that metachronous occurrence of GIST of the gastrointestinal tract and adenocarcinoma of stomach is rare and further metastasis of one tumour into the other makes this case a rare one as per available literature.