A Case Report of α-fetoprotein Producing Gastric Adenocarcinoma with Portal Venous Thrombosis

Kenta Kobashi, Tadashi Horimi, Tadanori Ishikawa, Taku Tanaka, Etsuhiro Uchida*

Department of Surgery, Kochi Municipal Central Hospital
*Uchida Clinic

A case of α-fetoprotein (AFP) producing gastric carcinoma with portal venous tumor thrombosis was experienced. The patient was a 72-year-old man diagnosed as having gastric carcinoma, whose serum level of AFP was markedly elevated to 20,780 ng/ml. In laparotomy, gastric carcinoma was T₃, N₃, P₀, H₀, M₀, Stage IV a according to the General rules for the gastric cancer study. We found out an induration in the portal vein and performed the portogram. It revealed complete obstruction of the portal vein. We performed total gastrectomy, removal of the tumor thrombus and insertion the catheter into the portal vein. Histological examination showed that some tissues resembled hepatocellular carcinoma. Immunohistochemical study revealed that the gastric carcinoma, tumor thrombus and metastatic lymph node were positively stained with AFP-antiserum. Postoperative chemotherapy has been performed with 5-fluorouracil, mitomycin C and cisplatin, the patient is still alive for 5 months after operation.

Key words
portal venous tumor thrombosis of gastric carcinoma

Reprint requests
Kenta Kobashi Department of Surgery, Kochi Municipal Central Hospital
2-7-33 Sakuraichou, Kouchi, 780 JAPAN

Accepted
November 9, 1994

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