Irizato M, Minamiguchi K, Fujita Y, Yamaura H, Onaya H, Taiji R, Tanaka T, Inaba Y. Distinctive imaging features of liver metastasis from gastric adenocarcinoma with enteroblastic differentiation: A case report. World J Radiol 2025; 17(2): 104518 [DOI: 10.4329/wjr.v17.i2.104518]
Corresponding Author of This Article
Kiyoyuki Minamiguchi, MD, PhD, Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan. kiyo829@naramed-u.ac.jp
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mariko Irizato, Hidekazu Yamaura, Hiroaki Onaya, Yoshitaka Inaba, Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Aichi, Japan
Mariko Irizato, Kiyoyuki Minamiguchi, Ryosuke Taiji, Toshihiro Tanaka, Department of Diagnostic and Interventional Radiology, Nara Medical University, Kashihara 634-8522, Nara, Japan
Yasuko Fujita, Department of Diagnostic Pathology, Aichi Cancer Center Hospital, Nagoya 464-8681, Aichi, Japan
Author contributions: Irizato M and Minamiguchi K performed the literature search and wrote the paper; Taiji R and Tanaka T contributed to the evaluation of imaging findings and the literature review; Yamaura H, Onaya H, and Inaba Y provided the medical imaging; Fujita Y made substantial contributions to the analysis of pathological findings. All authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kiyoyuki Minamiguchi, MD, PhD, Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan. kiyo829@naramed-u.ac.jp
Received: December 24, 2024 Revised: January 23, 2025 Accepted: February 19, 2025 Published online: February 28, 2025 Processing time: 64 Days and 18.5 Hours
Abstract
BACKGROUND
Gastric adenocarcinoma with enteroblastic differentiation (GAED) is one of the common subtypes of alpha-foetoprotein (AFP)-producing gastric cancer. GAED frequently results in venous invasion and liver metastasis, the latter being particularly linked to a poor prognosis. So far, the evidence for liver metastases from AFP-producing gastric cancer is only focused on those from gastric hepatoid adenocarcinoma, owing to their imaging similarities with hepatocellular carcinoma. This case report describes the characteristic diagnostic imaging findings of liver metastasis from GAED.
CASE SUMMARY
A 65-year-old man who had undergone a pyloric gastrectomy for GAED two years ago was found to have a liver tumor in the hepatic segment 7, accompanied by elevated serum AFP levels. Dynamic contrast-enhanced computed tomography revealed the tumor showing peripheral-dominant enhancement in the arterial phase with persistent central enhancement in the delayed phase. Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging demonstrated a signal drop in the tumor periphery in chemical shift imaging, along with arterial enhancement. Additionally, rim-like hypointensity surrounding the tumor was observed in the hepatobiliary phase. Postresection examination confirmed the tumor to be a metastasis from GAED. Histopathological examination revealed severe invasion of the tumor into the portal vein and hepatic vein surrounding the tumor, which explained the imaging features.
CONCLUSION
The imaging features of blood flow alternations resulting from vascular invasion may be crucial to diagnosing liver metastases from GAED.
Core Tip: Accurate diagnosis of liver metastases from gastric adenocarcinoma with enteroblastic differentiation (GAED) and distinguishing it from other potential differentials, particularly hepatocellular carcinoma, is crucial owing to its association with a poor prognosis. The presence of elevated serum alpha-foetoprotein levels, as well as histopathological changes in the perilesional tissues surrounding the tumor, are the key characteristic findings of liver metastases from GAED. This report is the first to describe the characteristic imaging features of liver metastases from GAED based on the radiopathological correlation.
