Clinical Report: Prolonged Survival in a Patient with Alpha-Fetoprotein-Positive Hepatoid Adenocarcinoma of the Gallbladder

Background

Hepatoid adenocarcinoma of the gallbladder is a rare and aggressive variant of gallbladder carcinoma, often associated with poor prognosis and elevated alpha-fetoprotein levels. Understanding the clinical management of this rare cancer is crucial due to its complex histology and the limited treatment options available.

Data Highlights

Key Findings

• The patient was diagnosed with AFP-positive hepatoid adenocarcinoma after imaging and histopathological analysis.
• Next-generation sequencing revealed a TP53 mutation and EGFR copy number amplification.
• Postoperative serum AFP levels decreased significantly, indicating a response to treatment.
• The patient underwent radical resection followed by adjuvant transarterial chemoembolization (TACE) with epirubicin.
• As of January 2025, the patient has maintained a recurrence-free survival of 68 months.

Clinical Implications

Aggressive surgical intervention combined with targeted adjuvant therapy may improve outcomes in patients with alpha-fetoprotein-positive hepatoid adenocarcinoma of the gallbladder. Monitoring serum AFP levels can be a useful marker for treatment response.

Conclusion

This case underscores the potential for prolonged survival in patients with rare and aggressive forms of gallbladder cancer when treated with a comprehensive approach.

Related Resources & Content

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5. Hepatoid adenocarcinoma of the biliary tract: Clinicopathologic analysis of 9 institutional cases with literature review - ScienceDirect
6. ESMO Clinical Practice Guideline interim update on the management of biliary tract cancer - PMC
7. Hepatoid adenocarcinoma of the biliary tract: Clinicopathologic analysis of 9 institutional cases with literature review - ScienceDirect
8. ESMO Clinical Practice Guideline interim update on the management of biliary tract cancer - PMC