{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:28:46Z","timestamp":1791559726680,"version":"4.3.4"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatoid adenocarcinoma of the stomach (HAS) is a rare and aggressive gastric cancer variant with both glandular and hepatocellular differentiation. The AFP-producing subtype is strongly associated with early liver metastasis and poor prognosis, presenting significant diagnostic challenges due to its resemblance to hepatocellular carcinoma (HCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 68-year-old male presented with progressive dizziness and fatigue. Initial contrast-enhanced abdominal CT revealed a hypervascular gastric antral mass with quantitative enhancement values of 52 \u00b1 3 HU (arterial), 78 \u00b1 5 HU (portal), and 85 \u00b1 4 HU (delayed) in the submucosal layer. Serum AFP was markedly elevated at 918.88 ng\/mL. Gastroscopic biopsy confirmed AFP-producing HAS. The patient underwent Billroth II gastrectomy. Four months postoperatively, surveillance CT identified multiple new hypervascular liver metastases, prompting right hepatectomy followed by adjuvant radiochemotherapy. At three-month follow-up, the patient was asymptomatic with normalized tumor markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates the utility of quantitative CT enhancement analysis for characterizing the hypervascular phenotype of AFP-producing HAS and proposes a conceptual diagnostic framework to differentiate HAS from HCC. Multidisciplinary collaboration and systematic serum AFP screening in patients with gastric lesions are essential for optimal management of this aggressive malignancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1768282","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:50:24Z","timestamp":1774421424000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: AFP-producing gastric hepatoid adenocarcinoma with multiple liver metastases \u2013 integrating quantitative imaging and diagnostic decision analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Shi-Yu","family":"Zhong","sequence":"first","affiliation":[{"name":"Department of Radiology, Chongzhou Hospital of Traditional Chinese Medicine","place":["Chongzhou\/Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Rong","family":"Deng","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Jiao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Chongzhou Hospital of Traditional Chinese Medicine","place":["Chongzhou\/Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Yu","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Chongzhou Hospital of Traditional Chinese Medicine","place":["Chongzhou\/Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Ke","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of Chengdu University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Ming","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of Chengdu University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of Chengdu University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19860701)58:1<119::aid-cncr2820580121>3.0.co;2-u","article-title":"Hepatoid adenocarcinomas of the stomach. 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