AUTHOR=Yang Qian , Liu Yulin , Zhang Shuixia 

TITLE=Hepatoid adenocarcinoma of the stomach: CT findings

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1036763

DOI=10.3389/fonc.2023.1036763

ISSN=2234-943X

ABSTRACT=Abstract
Objective: To analyze the CT findings of hepatoid adenocarcinoma of the stomach (HAS) and improve diagnosis accuracy of this condition.
Methods: CT images of 22 pathologically confirmed  HAS patients were analyzed retrospectively, including 17 males and 5 females. The mean age was 61.41±9.83 years ranging from 36 to 80 years. We investigated the location of lesion, morphology, enhancement features, area of invasion into surrounding organs, lymph node metastasis and venous tumor thrombus.
Results: Among the 22 patients with HAS, the morphology of tumors included mass (n=5), focal ulcer (n=7), and infiltrating ulcer (n=10). Extraserous fat was invaded in 12 cases. Enhancement scans showed continuous enhancement in all cases. CT values of unenhanced scan, arterial phase and portal venous phase are 30.36±6.46HU, 60.91±17.80HU, and 75.64±22.09HU respectively. In 6 cases the tumor infiltrated surrounding organs: liver (n=1) and pancreas (n=2), and both liver and pancreas (n=3). In 16 out of 22 patients (72.3%), suspicious lymph node metastasis at CT imaging have been then confirmed by pathological specimens. Intrahepatic metastasis was found in 14 cases. 7 patients had venous tumor thrombus: 3 patients developed tumor thrombus in main trunk and intrahepatic branches of portal vein, 2 patients in portal vein, splenic vein and superior mesenteric vein simultaneously.
Conclusion: CT scans of HAS often show thickened gastric wall and infiltrating ulceration. Infiltration into extraserosal fat is often seen. Enhancement scans show continuous and progressive enhancement of lesions. Lymph node metastasis, intrahepatic metastasis and portal vein tumor thrombus are frequently.