AFP and adenocarcinoma: HAL was first reported by Ishikura et al. in 1990, with diagnostic criteria including: 1) AFP-producing cancer with tumor cells showing sheet-like or trabecular growth and coexisting adenocarcinoma or papillary adenocarcinoma and 2) cells resembling hepatocellular carcinoma, with centrally located nuclei and abundant eosinophilic cytoplasm in sheet-like or trabecular structures [4].