Hepatoid Adenocarcinoma of the Stomach Combined With Gastric Neuroendocrine Carcinoma: A Case Report

Both hepatoid adenocarcinoma of the stomach (HAS) and gastric neuroendocrine carcinoma (NEC) are rare subtypes of gastric cancer, characterized by aggressive behavior and poor prognosis, for which no definitive treatment regimen has been established to date. A 56-year-old male was diagnosed with HAS combined with NEC, accompanied by perigastric lymph node and liver metastases. Initially, he received EP chemotherapy, which was subsequently switched to a regimen of capecitabine plus oxaliplatin due to insufficient therapeutic response. Ultimately, the treatment was transitioned to a combination of immunotherapy and targeted therapy with Lenvatinib plus Envafolimab, owing to the development of capecitabine intolerance. The optimal management of this disease remains undefined, and conventional chemotherapy often results in suboptimal outcomes. However, in this case, the treatment with Lenvatinib plus Envafolimab appears to be an effective strategy for prolonging survival time and improving quality of life. Further experimental and clinical investigations are warranted to validate these findings and substantiate this therapeutic hypothesis.