Introduction:

Gastric cancer (GC) remains one of the most lethal malignancies worldwide and represents a major global public health concern. The most common histological subtypes are classically classified as intestinal and diffuse. According to the World Health Organization (WHO) classification, gastric adenocarcinomas are further categorized as papillary, mucinous, poorly cohesive, mixed, and tubular types. Hepatoid gastric adenocarcinoma is considered an exceptionally rare tumor, with an incidence ranging from 0.3% to 1.0% of all gastric cancers.

Clinical Case:

A 68-year-old male patient was diagnosed with hepatoid adenocarcinoma with adenosquamous overlap. He presented with epigastric pain and three episodes of coffee-ground emesis. Upper gastrointestinal endoscopy was performed, and biopsy samples were obtained. Based on histopathological and immunohistochemical analysis, the tumor was classified as a hepatoid subtype with adenosquamous overlap.

Discussion and Conclusion:

This case represents a true clinical and histopathological diagnostic challenge, as definitive characterization was achieved only through immunohistochemistry. Fundamental aspects of these histopathological subtypes are described, highlighting their low incidence and potential tumor histogenesis, with particular emphasis on their aggressive biological behavior and poor prognosis.

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