A Case Report of AFP-Producing Gastric Cancer with Portal Vein Tumor Thrombus

Kenichiro Yamashita, Hiroshi Shiroto, Yuji Sato, Shohei Osawa, Masao Kondo, Takahiro Oshima, Shigechika Kohashi, Norihiko Takahashi, Shusaku Takahashi, Tsuyoshi Shimamura, Yoshie Une, Junichi Uchino

First Department of Surgery, Hokkaido University School of Medicine

We report a case of alpha-fetoprotein (AFP)-producing gastric cancer with the distant components of liver metastasis and portal tumor thrombi. A 52-year-old man was admitted to our institute for Borrmann 3 type gastric cancer of the cardia, and his serum AFP level was extremely elevated to 818.5 ng/ml. The distant components were found in the postero-superior segment of the right hepatic lobe and within the right branch of the portal vein. Total gastrectomy and right lobectomy of the liver were carried out, followed by thrombectomy of the portal tumor. These three lesions were histologically analogous and consisted of poorly differentiated adenocarcinoma. AFP was also demonstrated in the respective cytoplasm of these tumor cells by immunohistochemical staining. The serum AFP level of the patient had declined to 33.3 ng/ml after surgery. It is reportedly very rare for a patient with gastric cancer to have liver metastasis and portal tumor thrombi concurrently. However, when we attend the patients with high serum levels of AFP who have a space-occupying lesion of the liver and portal tumor thrombi, we should also bear in mind the possibility of AFP-producing gastric cancer as their origin.

Key words
AFP-producing gastric cancer, portal tumor thrombus, liver metastasis

Reprint requests
Kenichiro Yamashita First Department of Surgery, Hokkaido University School of Medicine
N-15 W-7 Kita-ku, Sapporo, 060 JAPAN

Accepted
June 12, 1996

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