Abdominal Radiology

, Volume 42, Issue 10, pp 2402–2409 | Cite as

CT features of hepatic metastases from hepatoid adenocarcinoma

  • Min-Yung Chang
  • Hye Jin Kim
  • Seung Hyun Park
  • Hyunki Kim
  • Dong Kyu Choi
  • Joon Seok Lim
  • Mi-Suk Park
  • Myeong-Jin Kim
  • Honsoul KimEmail author



The purpose of this study was to report the imaging presentation of hepatic metastases from hepatoid adenocarcinoma (HAC).


We retrospectively identified 11 patients (10 men and 1 woman; median age 66) with HAC liver metastasis who underwent contrast-enhanced computed tomography (CT) which included arterial phase and portal venous phase. Two radiologists analyzed the imaging parameters, which included the enhancement pattern on arterial and portal phase images, necrosis, venous thrombi, and overall imaging diagnosis, and arrived at a consensus.


On arterial phase, the liver lesions had global hyper-enhancement (n = 0), heterogeneous hyper-enhancement (63.6%; n = 7/11), peripheral hyper-enhancement (n = 0), iso-enhancement (n = 0/11), or hypo-enhancement (36.4%; n = 4/11). On portal venous phase, homogenous hypo-enhancement (18.2%; n = 2/11) and heterogenous hypo-enhancement (81.8%; n = 9/11) were observed. Venous thromboses occurred in four patients (36.4%; n = 4/11). The overall imaging diagnoses were “HCC-like” in seven patients (63.6%; n = 7/11), “indeterminable” in 1 patient (9.1%; n = 1/11), and “HCC-unlike” in three patients (27.3%; n = 3/11).


The imaging features of HAC liver metastasis were varied. Arterial phase enhancement coupled with venous phase washout (resembling HCC imaging features) was a major finding, but arterial phase hypo-enhancement (distinct from HCC imaging features) was also frequently encountered.


Hepatoid adenocarcinoma CT Liver metastasis Hepatocellular carcinoma 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

A waiver of informed consent was obtained from the institutional review board as this was a retrospective study and all patients underwent CT as part of their clinical work-up.


  1. 1.
    Ye MF, Tao F, Liu F, Sun AJ (2013) Hepatoid adenocarcinoma of the stomach: a report of three cases. World J Gastroenterol 19(27):4437–4442. doi: 10.3748/wjg.v19.i27.4437 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Su JS, Chen YT, Wang RC, et al. (2013) Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. World J Gastroenterol 19(3):321–327. doi: 10.3748/wjg.v19.i3.321 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Ishikura H, Kanda M, Ito M, Nosaka K, Mizuno K (1990) Hepatoid adenocarcinoma: a distinctive histological subtype of alpha-fetoprotein-producing lung carcinoma. Virchows Archiv A 417(1):73–80. doi: 10.1007/bf01600112 CrossRefGoogle Scholar
  4. 4.
    Hocking GR, Shembrey M, Hay D, Östör AG (1995) Alpha-fetoprotein-producing adenocarcinoma of the sigmoid colon with possible hepatoid differentiation. Pathology 27(3):277–279. doi: 10.1080/00313029500169113 CrossRefPubMedGoogle Scholar
  5. 5.
    Chang YC, Nagasue N, Abe S, et al. (1991) alpha Fetoprotein producing early gastric cancer with liver metastasis: report of three cases. Gut 32(5):542–545CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Nagai E, Ueyama T, Yao T, Tsuneyoshi M (1993) Hepatoid adenocarcinoma of the stomach. A clinicopathologic and immunohistochemical analysis. Cancer 72(6):1827–1835CrossRefPubMedGoogle Scholar
  7. 7.
    Ishikura H, Kishimoto T, Andachi H, Kakuta Y, Yoshiki T (1997) Gastrointestinal hepatoid adenocarcinoma: venous permeation and mimicry of hepatocellular carcinoma, a report of four cases. Histopathology 31(1):47–54CrossRefPubMedGoogle Scholar
  8. 8.
    Uefuji K, Ichikura T, Tamakuma S (1994) Roles of histological findings and serum AFP levels in the prognosis of AFP-producing gastric cancers. Jpn J Clin Oncol 24(3):135–140PubMedGoogle Scholar
  9. 9.
    Liu X, Cheng Y, Sheng W, et al. (2010) Analysis of clinicopathologic features and prognostic factors in hepatoid adenocarcinoma of the stomach. Am J Surg Pathol 34(10):1465–1471. doi: 10.1097/PAS.0b013e3181f0a873 CrossRefPubMedGoogle Scholar
  10. 10.
    Terracciano LM, Glatz K, Mhawech P, et al. (2003) Hepatoid adenocarcinoma with liver metastasis mimicking hepatocellular carcinoma: an immunohistochemical and molecular study of eight cases. Am J Surg Pathol 27(10):1302–1312CrossRefPubMedGoogle Scholar
  11. 11.
    Lin YY, Chen CM, Huang YH, et al. (2015) Liver metastasis from hepatoid adenocarcinoma of the stomach mimicking hepatocellular carcinoma: dynamic computed tomography findings. World J Gastroenterol 21(48):13524–13531. doi: 10.3748/wjg.v21.i48.13524 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Moon JY, Kim GH, Cheong JH, et al. (2012) A case of hepatic metastasis of gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma. Korean J Gastroenterol 60(4):262–266CrossRefPubMedGoogle Scholar
  13. 13.
    Jo JM, Kim JW, Heo SH, et al. (2012) Hepatic metastases from hepatoid adenocarcinoma of stomach mimicking hepatocellular carcinoma. Clin Mol Hepatol 18(4):420–423. doi: 10.3350/cmh.2012.18.4.420 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Lin CW, Hsu CC, Chang HC, et al. (2009) Hepatoid adenocarcinoma of the stomach with liver metastasis mimicking hepatocellular carcinoma: a case report. Cases J 2:6317. doi: 10.4076/1757-1626-2-6317 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Kashani A, Ellis JC, Kahn M, Jamil LH (2015) Liver metastasis from hepatoid adenocarcinoma of the esophagus mimicking hepatocellular carcinoma. Gastroenterol Rep (Oxf). doi: 10.1093/gastro/gov021 Google Scholar
  16. 16.
    Bazeries P, Barral M, Labrife M, Soyer P, Aube C (2016) Hepatic metastases from gastric hepatoid adenocarcinoma: an unusual cause of capsular retraction of the liver. Diagn Interv Imaging 97(9):931–934. doi: 10.1016/j.diii.2016.06.001 CrossRefPubMedGoogle Scholar
  17. 17.
    Sheng RF, Xie YH, Ji Y, et al. (2016) MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers. Abdom Radiol (NY). doi: 10.1007/s00261-016-0811-y Google Scholar
  18. 18.
    de Campos RO, Semelka RC, Azevedo RM, et al. (2012) Combined hepatocellular carcinoma-cholangiocarcinoma: report of MR appearance in eleven patients. J Magn Reson Imaging 36(5):1139–1147. doi: 10.1002/jmri.23754 CrossRefPubMedGoogle Scholar
  19. 19.
    Choi JY, Lee JM, Sirlin CB (2014) CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part II. Extracellular agents, hepatobiliary agents, and ancillary imaging features. Radiology 273(1):30–50. doi: 10.1148/radiol.14132362 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Sica GT, Ji H, Ros PR (2000) CT and MR Imaging of Hepatic Metastases. AJR Am J Roentgenol 174(3):691–698. doi: 10.2214/ajr.174.3.1740691 CrossRefPubMedGoogle Scholar
  21. 21.
    Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system, 4th edn. Geneva: World Health OrganizationGoogle Scholar
  22. 22.
    Gálvez-Muñoz E, Gallego-Plazas J, Gonzalez-Orozco V, et al. (2009) Hepatoid adenocarcinoma of the stomach–a different histology for not so different gastric adenocarcinoma: a case report. Int Sem Surg Oncol 6(1):1–6. doi: 10.1186/1477-7800-6-13 CrossRefGoogle Scholar
  23. 23.
    Zizi-Sermpetzoglou A, Moustou E, Tsavari A, et al. (2013) Gastric hepatoid adenocarcinoma. Hellenic J Surg 85(5):355–359. doi: 10.1007/s13126-013-0065-x CrossRefGoogle Scholar
  24. 24.
    Lin CY, Yeh HC, Hsu CM, Lin WR, Chiu CT (2015) Clinicopathologial features of gastric hepatoid adenocarcinoma. Biomed J 38(1):65–69. doi: 10.4103/2319-4170.126860 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Min-Yung Chang
    • 1
    • 2
    • 3
  • Hye Jin Kim
    • 1
    • 2
    • 4
  • Seung Hyun Park
    • 1
    • 2
  • Hyunki Kim
    • 5
  • Dong Kyu Choi
    • 6
  • Joon Seok Lim
    • 1
    • 2
  • Mi-Suk Park
    • 1
    • 2
  • Myeong-Jin Kim
    • 1
    • 2
  • Honsoul Kim
    • 1
    • 2
    Email author
  1. 1.Department of RadiologyYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Research Institute of Radiological ScienceYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of RadiologySeoul National University HospitalSeoulRepublic of Korea
  4. 4.Department of RadiologyAjou University School of MedicineSuwonRepublic of Korea
  5. 5.Department of PathologyYonsei University College of MedicineSeoulRepublic of Korea
  6. 6.New Drug Development CenterDaegu-Gyeongbuk, Medical Innovation Foundation (DGMIF)DaeguRepublic of Korea

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