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CASE REPORT article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1513604
This article is part of the Research Topic Crosstalk in Tumor Microenvironments: Shaping Early Drug and Immunotherapy Strategies View all 4 articles

Chemotherapy plus sintilimab for the treatment of gastroesophageal junction hepatoid adenocarcinoma with liver metastasis: A case study with literature review

Provisionally accepted
Genlin Lu Genlin Lu 1*Jiarui Tu Jiarui Tu 2Jinming Tu Jinming Tu 3Renya Jiang Renya Jiang 4
  • 1 Department of General Surgery, longyou county people's hospital, Quzhou, China
  • 2 Clinical Medicine Department, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 3 Department of Gastroenterology, longyou county people's hospital, Quzhou, China
  • 4 Department of Hepatobiliary surgery, Quzhou City People's Hospital, Quzhou, China

The final, formatted version of the article will be published soon.

    Objective: To elucidate the clinicopathological features and treatment of metastatic gastroesophageal junction hepatoid adenocarcinoma (GEJ HAC)using a case study and literature review. Methods: Clinical presentation, results of histology and immunohistochemistry, and next-generation sequencing(NGS) in a patient with GEJ HAC metastasizing to the liver were reviewed. Chemotherapy (SOX or S-1) plus sintilimab was administered. Results: A 65-year-old male patient with a history of hypertension was admitted to the hospital due to a one-week increase in serum AFP levels.There was a small intraluminal mass at the GEJ and a metastatic lesion in liver segment VIII, as well as enlarged perigastric and retroperitoneal lymph nodes.Tumor cells in both the GEJ and liver tissue exhibited a glandular shape with a nest-like adenoid structure. Immunohistochemical (IHC) analysis of the GEJ tissue showed positivity for AFP, CA19-9, CK7, CK20, MUC-1, P53 (wild type), Glypican-3, and HepPar-1, and negativity for Arginase-1, CD10, and Her-2. In the metastatic liver tissue, IHC testing demonstrated positivity for AFP, CD10, CK19, CK20, HepPar-1, MUC-1, Ki-67, and P53 (wild type), while CK7 was negative. The NGS report of GEJ mass indicated that the JAK2 and TP53 genes harbored missense mutations, while the MLH1, MSH2, MSH6, PMS2, ERBB2, EGFR, PIK3CA, APC, CTNNB1, CDH1, and DPYD genes were normal. The patient's serum levels of CEA, CA19-9, and AFP were sharply decreased. The patient achieved a major pathological response (MPR) and remains in a progression-free stage. Conclusions: Sintilimab-based chemotherapy has proven efficacy in achieving a MPR and maintaining a progression-free state for a patient with GEJ HAC that has metastasized to the liver. KEYWORDS gastroesophageal junction, hepatoid adenocarcinoma, chemotherapy, sintilimab 1 IntroductionGastroesophageal junction(GEJ) adenocarcinoma is one of the deadliest cancers worldwide (1). Hepatoid adenocarcinoma (HAC), a highly aggressive, metastatic, and potentially chemosensitive tumor, is characterized by aberrant hepatocellular differentiation occurring in extrahepatic organs, such as the stomach(2). Surgery combined with adjuvant therapy has improved clinical outcomes for GEJ HAC (3,

    Keywords: gastroesophageal junction, hepatoid adenocarcinoma, chemotherapy, Sintilimab, liver metastasis

    Received: 18 Oct 2024; Accepted: 08 Jan 2025.

    Copyright: © 2025 Lu, Tu, Tu and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Genlin Lu, Department of General Surgery, longyou county people's hospital, Quzhou, China

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