多学科协作诊疗1例胃肝样腺癌伴肝转移合并胰腺神经内分泌肿瘤OA

Objective To summarize the application of multidisciplinary team(MDT)management in a patient with hepatoid adenocarcinoma of the stomach(HAS)complicated by multi-organ involvement,and to evaluate the value of MDT in the diagnosis and comprehensive treatment of this rare gastric cancer subtype.Methods Clinical data of a patient diagnosed with HAS with liver metastasis and a concurrent pancreatic neuroendocrine tumor at Jiangsu Cancer Hospital were retrospectively reviewed.Endoscopy,CT/MRI,PET-CT,liver biopsy,and immunohistochemistry were integrated,and three MDT discussions were documented.Diagnostic challenges,surgical strategy for multi-organ resection,and perioperative management were analyzed.Results The patient presented with a cardia lesion and mildly elevated AFP,with imaging lacking typical HAS features.MDT-guided evaluation confirmed HAS with liver metastasis and a pancreatic neuroendocrine tumor.The patient underwent radical proximal gastrectomy with D2 lymphadenectomy,hepatic tumor resection,and spleen-preserving distal pancreatectomy,followed by SOX chemotherapy.Recovery was favorable,with no recurrence to date.Conclusions MDT improves diagnostic accuracy,enhances the safety and feasibility of multi-organ resection,and supports individualized perioperative and postoperative management in complex HAS cases.