Cargando…
Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation
Alpha-fetoprotein (AFP)-producing gastric carcinomas (AFPGCs) are relatively rare tumors known to have a poor prognosis and commonly found as advanced lesions. Histologically, AFPGCs have been described as having hepatoid and fetal enteric (enteroblastic) morphology and are associated with conventio...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506198/ https://www.ncbi.nlm.nih.gov/pubmed/32999644 http://dx.doi.org/10.1159/000508413 |
_version_ | 1783584979000754176 |
---|---|
author | Iwaya, Mai Riddell, Robert Asano, Koji Kobayashi, Kazuo Uehara, Takeshi Ota, Hiroyoshi |
author_facet | Iwaya, Mai Riddell, Robert Asano, Koji Kobayashi, Kazuo Uehara, Takeshi Ota, Hiroyoshi |
author_sort | Iwaya, Mai |
collection | PubMed |
description | Alpha-fetoprotein (AFP)-producing gastric carcinomas (AFPGCs) are relatively rare tumors known to have a poor prognosis and commonly found as advanced lesions. Histologically, AFPGCs have been described as having hepatoid and fetal enteric (enteroblastic) morphology and are associated with conventional adenocarcinomas. Prior studies reported a hepatoid component present only in invasive areas and hypothesized that AFPGCs may develop hepatoid features during the process of tumor invasion. We report three cases of AFP-producing early gastric cancer which had an intramucosal hepatoid component. Immunohistochemistry showed that the hepatoid component was diffusely immunoreactive for SALL4, AFP, arginase-1, and HepPar1, and focally for CDX2 and PDX1. An intramucosal transition between the hepatoid component and conventional intramucosal adenocarcinoma was identified. Two patients also had a coexistent fetal enteric component, which was admixed with a hepatoid component. Although at an early stage one patient subsequently developed liver metastasis and a second patient was suspected of having liver metastasis, these were not biopsy-proven. The latter patient had a previous history of hepatocellular carcinoma (HCC) and SALL4 was used on the HCC to distinguish metastatic/further HCC from a gastric metastatic primary with hepatoid differentiation. |
format | Online Article Text |
id | pubmed-7506198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-75061982020-09-29 Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation Iwaya, Mai Riddell, Robert Asano, Koji Kobayashi, Kazuo Uehara, Takeshi Ota, Hiroyoshi Case Rep Gastroenterol Case Series Alpha-fetoprotein (AFP)-producing gastric carcinomas (AFPGCs) are relatively rare tumors known to have a poor prognosis and commonly found as advanced lesions. Histologically, AFPGCs have been described as having hepatoid and fetal enteric (enteroblastic) morphology and are associated with conventional adenocarcinomas. Prior studies reported a hepatoid component present only in invasive areas and hypothesized that AFPGCs may develop hepatoid features during the process of tumor invasion. We report three cases of AFP-producing early gastric cancer which had an intramucosal hepatoid component. Immunohistochemistry showed that the hepatoid component was diffusely immunoreactive for SALL4, AFP, arginase-1, and HepPar1, and focally for CDX2 and PDX1. An intramucosal transition between the hepatoid component and conventional intramucosal adenocarcinoma was identified. Two patients also had a coexistent fetal enteric component, which was admixed with a hepatoid component. Although at an early stage one patient subsequently developed liver metastasis and a second patient was suspected of having liver metastasis, these were not biopsy-proven. The latter patient had a previous history of hepatocellular carcinoma (HCC) and SALL4 was used on the HCC to distinguish metastatic/further HCC from a gastric metastatic primary with hepatoid differentiation. S. Karger AG 2020-08-26 /pmc/articles/PMC7506198/ /pubmed/32999644 http://dx.doi.org/10.1159/000508413 Text en Copyright © 2020 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Case Series Iwaya, Mai Riddell, Robert Asano, Koji Kobayashi, Kazuo Uehara, Takeshi Ota, Hiroyoshi Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation |
title | Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation |
title_full | Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation |
title_fullStr | Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation |
title_full_unstemmed | Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation |
title_short | Alpha-Fetoprotein-Producing Early Gastric Cancer with Intramucosal Hepatoid and Fetal Enteric Differentiation |
title_sort | alpha-fetoprotein-producing early gastric cancer with intramucosal hepatoid and fetal enteric differentiation |
topic | Case Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506198/ https://www.ncbi.nlm.nih.gov/pubmed/32999644 http://dx.doi.org/10.1159/000508413 |
work_keys_str_mv | AT iwayamai alphafetoproteinproducingearlygastriccancerwithintramucosalhepatoidandfetalentericdifferentiation AT riddellrobert alphafetoproteinproducingearlygastriccancerwithintramucosalhepatoidandfetalentericdifferentiation AT asanokoji alphafetoproteinproducingearlygastriccancerwithintramucosalhepatoidandfetalentericdifferentiation AT kobayashikazuo alphafetoproteinproducingearlygastriccancerwithintramucosalhepatoidandfetalentericdifferentiation AT ueharatakeshi alphafetoproteinproducingearlygastriccancerwithintramucosalhepatoidandfetalentericdifferentiation AT otahiroyoshi alphafetoproteinproducingearlygastriccancerwithintramucosalhepatoidandfetalentericdifferentiation |