Early Gastric Cancer of Type IIa + IIc Producing α-fetoprotein with Liver Metastasis -Report of a Case-

Masashi Kato, Kazuo Kinoshita, Toshiharu Sawa, Sotohiro Yoshimitsu, Yutaka Yonemura*, Kouichi Miwa*, Itsuo Miyazaki*, Yutaka Matsui**

Department of Surgery, National Sanatorium Tsuruga Hospital
*Department of Surgery II, School of Medicine, Kanazawa University
**Department of Pathology I, School of Medicine, Kanazawa University

The patient is a 58-year-old man, who was diagnosed by a medical checkup as having gastric cancer and came to our hospital for surgery. Gastric X-P·endoscopy diagnosed the case as IIa + IIc type early gastric cancer on the posterior wall of the antrum. Except for a high 9l.3 ng/ml serum α-fetoprotein (AFP) level, no abnormal findings were noted in blood biochemical tests, abdominal ultrasonography and computed tomography. While subtotal gastrectomy with R₂, dissection was carried out, a white tumor 2 mm in diameter was found on the surface of anterior segment of liver and was extirpated. Histological findings in the gastric cancer showed poorly differentiated adenocarcinoma (medullary type) infiltrating into the submucosal layer, without lymphnode metastasis and metastasis was noted in a small focus of the liver. Immunohistological examination revealed AFP in both the primary lesion and the metastatic hepatic lesion. The postoperative course was favorable, but in view of the high possibility of micrometastasis, we started administering UFT and performed two courses of hepatoarterial infusion with Cisplatin, Mitomycin C and Etoposide. Thanks to this chemotherapy, AFP, which increased again postoperatively, decreased to reach WNL.

Key words
α-fetoprotein producing gastric cancer, early gastric cancer, liver metastasis

Reprint requests
Masashi Kato Department of Surgery II, Kanazawa Medical University
Uchinada-machi, Kahoku-gun, Ishikawa, 920-02 JAPAN

Accepted
June 13, 1990

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