Abstract

Poster Session ASICON 2010

Title : “ A RARE CASE OF HEPATOID VARIETY OF ADENOCARCINOMA OF STOMACH

WITH UNUSUAL
FEATURES “

Author & Presenter : Dr.Dilip Dutta

Co-authors : Prof Basudev Sil, Dr. R.S. Moral.

Case summary : A 16 years old female presented with features of gastric outlet
obstruction, malena and severe anaemia. Upper G I Endoscopy revealed a
circumferential mass lesion at the antrum of stomach occluding the lumen.
Endoscopic biopsy revealed poorly differentiated malignant lesion. Pre op imaging
of abdomen was normal . Patient was managed by D1 distal gastrectomy.
Histopathological examination revealed hepatoid variety of adenocarcinoma of
stomach infiltrating the muscle coat of stomach and extending into the serosa with
metastasis in all resected gastric lymph nodes, surgical margin free of lesion, no
metastases in omental tissue. On immunohistochemistry, the tumor cells express
Cytokeratin and alpha feto protein and are immune negative for C-kit, CD 34,
Desmin, SMA & S-100 protein. Post operative recovery was uneventful. Now the
patient is on regular follow up and is on chemotherapy,

Conclusion : Hepatoid adenocarcinoma is a rare tumor associated with a very poor

prognosis. It is a type of gastric carcinoma having both glandular and hepatocellular
differentiation and with increased propensity for vascular invasion and hepatic
metastases usually at diagnosis. This variety of adenocarcinoma is seen in elderly
age group. In our case the patient presented early at 16 yrs of age and at diagnosis
no distant metastatic deposit was seen in the liver. The patient was managed
surgically followed by chemotherapy and followed up.