Gastric hepatoid adenocarcinoma and familial investigation: does it always produce alpha-fetoprotein?

We present the case of a 68-year-old Caucasian man with gastric hepatoid adenocarcinoma without increased levels of alpha-fetoprotein (AFP) in the serum. The patient had a strong history of gastric cancer in his family, affecting seven members, including a brother and a sister. The patient underwent subtotal gastrectomy, but 4 months later presented hepatic metastases, and 6 months after the initial diagnosis he succumbed to the disease. Immunohistochemical tests showed that the tumour was positive for AFP, hepatocyte paraffin 1, and neuron-specific enolase, but negative for synaptophysin and chromogranin. Previously reported cases of hepatoid gastric tumours showed that they produce large amounts of AFP and that they have a poor prognosis.