A Case of Gastric Undifferentiated Carcinoma with Focal Yolk Sac Tumor and Hepatoid Carcinoma Differentiation

We report herein a case of gastric undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. A 57-year-old man was referred after a gastroscopy for anemia evaluation. Gastroscopy revealed an approximately 3 cm ulcerofungating mass occupying the greater curvature of stomach body. Biopsy results revealed a poorly differentiated adenocarcinoma. Left gastric lymph node was enlarged, but there were no evidence of distant metastasis on the abdominal CT. He underwent a radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. Immunohistochemical staining revealed that the tumor cells were focal positive for AFP, anti-hepatocyte antibody.

A Case of Gastric Undifferentiated Carcinoma with Choriocarcinomatous and Hepatoid Carcinomatous Differentiation / 대한소화기내시경학회지

Here we report a case of a patient with gastric undifferentiated carcinoma associated with choriocarcinomatous and hepatoid carcinomatous differentiation. A 62-year-old man was referred after a healthcare screening gastroscopy. Gastroscopy revealed an approximately 3x3 cm ulcerofungating mass in the posterior wall of the antrum. Biopsy results revealed a moderately differentiated adenocarcinoma. The initial serum alpha-FP levels were above 350 ng/mL. An abdominal CT scan revealed focal wall thickening along the greater curvature of the gastric antrum, with perigastric fat invasion and enlarged multiple perigastric lymph nodes. He underwent a palliative radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma associated with choriocarcinomatous and hepatoid carcinomatous differentiation. Immunohistochemical staining revealed that the tumor cells were positive for human chorionic gonadotropin (hCG), alpha-FP, and anti-hepatocyte antibody.