Two Cases of Primary Gastric Adenocarcinoma with Enteroblastic Differentiation (ACED)

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  • 胃原発胎児消化管上皮類似癌の2例
  • イ ゲンパツ タイジ ショウカカン ジョウヒ ルイジガン ノ 2レイ

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Abstract

<p>The histopathology of adenocarcinoma with enteroblastic differentiation (ACED) is similar to gastrointestinal epithelium in the early embryonic period, and it is defined by positive expression of alpha-feto protein (AFP), Glypican3, or SALL4. Two cases of ACED are reported along with a review of the literature.</p><p>Case 1 : An 84-year-old man presented with an elevated AFP level and anorexia during hepatitis C treatment. He was diagnosed with a type 2 tumor of the gastric body and underwent distal gastrectomy. The histopathological findings showed moderate to poorly differentiated adenocarcinoma with a clear, rosette-like tubular structure, AFP+/SALL4+, which was diagnosed as ACED. The serum AFP level returned to the normal range seven months after surgery.</p><p>Case 2 : A 76-year-old man showed a CEA increase during follow-up after hepatocellular carcinoma surgery. He was diagnosed with type 3 gastric cancer and underwent total gastrectomy. The diagnosis of ACED was confirmed on histopathology : SALL4+ columnar cells with clear endoplasmic reticulum similar to fetal gastrointestinal epithelium. He has survived more than half a year and is currently undergoing adjuvant chemotherapy.</p>

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