Jae Hoon Lee, et al. bladder found liver or lymph nodes metastasis in three cases. The other cases were limited by lack a description of metastasis or recurrence, and a relatively short post- operative follow-up period (8 to 15 months). In general, as seen in this case, HAC has a poor prognosis with frequent liver and lymph nodes metastasis. Taken together, tumor location, radiologic features and high AFP are clues for diagnosis of HAC of the gallblad- der. Although this is a very rare malignancy, awareness of its existence is critical to avoid misdiagnosis, especially since it is associated with a poor prognosis. Therefore, we suggest that aggressively radical resection, with the aim of complete tumor removal and cure, is the treatment of choice. In addition, close follow-up with frequent AFP check and abdominal imaging is recommended. CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported. REFERENCES 1. Supriatna Y, Kishimoto T, Uno T, Nagai Y, Ishikura H. Evidence for hepatocellular differentiation in alpha-feto- protein-negative gastric adenocarcinoma with hepatoid morphology: a study with in situ hybridisation for albu- min mRNA. Pathology 2005;37:211-5. 2. Vardaman C, Albores-Saavedra J. Clear cell carcinomas of the gallbladder and extrahepatic bile ducts. Am J Surg Pathol 1995;19:91-9. 3. Nakashima H, Nagafuchi K, Satoh H, Takeda K, Yamasaki T, Yonemasu H, et al. Hepatoid adenocarcinoma of the gallbladder. J Hepatobiliary Pancreat Surg 2000;7:226-30. 4. Sakamoto K, Monobe Y, Kouno M, Moriya T, Sasano H. Hepatoid adenocarcinoma of the gallbladder: case report and review of the literature. Pathol Int 2004;54:52-6. 5. Sakamoto K, Kimura N, Tokumura H, Ogasawara T, Moriya T, Sasano H. Hepatoid adenocarcinoma of the gallbladder. Histopathology 2005;47:649-51. 6. Gakiopoulou H, Givalos N, Liapis G, Agrogiannis G, Patsouris E, Delladetsima I. Hepatoid adenocarcinoma of the gallbladder. Dig Dis Sci 2007;52:3358-62. 7. van den Bos IC, Hussain SM, Dwarkasing RS, Stoop H, Zondervan PE, Krestin GP, et al. Hepatoid adenocarci- noma of the gallbladder: a mimicker of hepatocellular carcinoma. Br J Radiol 2007;80:e317-20. 8. Ishikura H, Kishimoto T, Andachi H, Kakuta Y, Yoshiki T. Gastrointestinal hepatoid adenocarcinoma: venous per- meation and mimicry of hepatocellular carcinoma, a re- port of four cases. Histopathology 1997;31:47-54. 9. Maitra A, Murakata LA, Albores-Saavedra J. Immunoreac- tivity for hepatocyte paraffin 1 antibody in hepatoid ad- enocarcinomas of the gastrointestinal tract. Am J Clin Pathol 2001;115:689-94. 10. Terracciano LM, Glatz K, Mhawech P, Vasei M, Lehmann FS, Vecchione R, et al. Hepatoid adenocarcinoma with liver metastasis mimicking hepatocellular carcinoma: an im- munohistochemical and molecular study of eight cases. Am J Surg Pathol 2003;27:1302-12. 444 thesurgery.or.kr