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Case Reports
. 2021 Sep 13;2021(9):omab078.
doi: 10.1093/omcr/omab078. eCollection 2021 Sep.

Hepatoid adenocarcinoma of the stomach with PIK3Ca mutation during pregnancy: A case report with molecular profile

Anastasija Ranceva  1 , Rokas Stulpinas  2 , Rimvydas Norvilas  1 , Ugnius Mickys  2
Affiliations
Case Reports

Hepatoid adenocarcinoma of the stomach with PIK3Ca mutation during pregnancy: A case report with molecular profile

Anastasija Ranceva et al. Oxf Med Case Reports. .

Abstract

Hepatoid adenocarcinoma is an extremely aggressive special subtype of gastric tumors. It can be lethal as no standard treatment options for this type of gastric cancer exist. Here, we describe a very rare case of a young female on her 21st week of pregnancy who was diagnosed with stage IV hepatoid adenocarcinoma of the stomach with elevated α fetoprotein (AFP) level. Gene mutation analysis performed by next-generation sequencing identified somatic mutations in the PIK3CA gene. Despite the treatment, patient died 2 months after the initial disease presentation. To our best knowledge, this case represents the first report of pregnancy-associated hepatoid gastric adenocarcinoma with the PIK3CA gene mutations, which can provide further clues for the understanding of molecular features of this type of tumor that can reflect biological behavior and may lead to further effective treatment options.

Keywords: PIK3CA, NGS; gastric cancer; hepatoid adenocarcinoma; pregnancy.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging: A) thickening of the gastric wall, B) perigastric lymph node enlargement and C) pleural effusion (red arrows).
Figure 2
Figure 2
Esophagogastroduodenoscopy imaging: an infiltrative ulcerated tumor of the stomach 4 cm in size (white arrows).
Figure 3
Figure 3
Biopsy (hematoxylin & eosin, 10× magnification): focal gland formation (blue arrows).
Figure 4
Figure 4
Biopsy (hematoxylin & eosin, 15× magnification): solid sheets of large polygonal cells with focal nuclear pleomorphism (blue arrow) and mitoses (green arrow).
Figure 5
Figure 5
Biopsy (Hep-Par-1 immunohistochemistry, 10× magnification): focal positive cytoplasmic reaction (red arrows).
Figure 6
Figure 6
Biopsy (Alpha-fetoprotein (AFP) immunohistochemistry, 10× magnification): focal positive cytoplasmic reaction (red arrows).
See this image and copyright information in PMC

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