A Case of Alpha-fetoprotein Producing Gastric Cancer Suggestive of Multiple Differentiation and Proliferation

Tetsuro Matsuda, Shigenori Akagi

Department of Surgery, National Insurance Kumihama Hospital

An 84-year-old man was diagnosed as having an alpha-fetoprotein (AFP)-producing cancer occupying the C region, and total gastrectomy was carried out. The preoperative serum level of AFP was abnormally high, 39.4 ng/ml and AFP deposits were revealed by immunohistochemical study. When liver metastasis was found 10 months after the operation, serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were high levels, although AFP was within normal limits. The same pattern was found in the ascitic fluid and cystic fluid of liver metastasis. Generally, the serum AFP level increases with the advance in tumor growth and liver metastasis, and it may be useful for predicting the outcome of AFP-producing gastric cancer. This case is the opposite and it is assumed that the tumor cells have the ability to cause various forms of differentiation and proliferation. Therefore not only AFP but also various other tumor markers should be measured and followed even in an AFP-producing cancer.

Key words
alpha-fetoprotein producing cancer, tumor markers, liver metastasis

Reprint requests
Tetsuro Matsuda Department of Surgery, National Insurance Kunihama Hospital
161 Kumihama-cho, Kumanogun, Kyoto, 629-34 JAPAN

Accepted
October 7, 1992

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