A Case of Advanced Gastric Carcinoma Producing Alpha-fetoprotein with Multiple Liver Metastases in which Intrahepatic Chemotherapy was Effective Postgastrectomy

Yasushi Suzuki, Masashi Watanabe, Hiroko Nonaka^*, Hajime Kase, Natsuki Tokura, Makoto Kikuchi, Hiroshi Matsumoto, Kazuo Kobayashi, Michio Akima^* and Toshihumi Yoshio

First Department of Surgery, First Department of Pathorogy^*, Toho University

A case of AFP (α-fetoprotein) producing gastric carcinoma successfully treated with post-operative intrahepatic chemotherapy in reported with a review of the literature. A 73 year old male was admitted complaining of epigastralgia. He was diagnosed as having advanced gastric cancer with multiple liver metastases by endscopy and computed tomography. Serum AFP level was 296.8ng/ml and serum CEA level was 3.2ng/ml. Distal gastrectomy (D2) and hepatic artery cannulation was performed. Histopathological study showed moderately differentiated adenocarcinoma surrounding a hepatoid adenocarcinoma. Immunohistochemical study showed a few AFP-positive tumor cells in the hepatoid structure. Post-operative intrahepatic chemotherapy with 5FU 500mg/body/day was performed 10 times and the therapeutic effect by CT showed a complete response in the liver. He has been well without any evidence of recurrence for 4 years and 2 months after the surgery and this treatment.

Key words
α-fetoprotein, intrahepatic chemothrapy, hepatoid adenocarcinoma

Reprint requests
Yasushi Suzuki Department of Surgery, Toho University6-11-1Omori-Nishi, Otaku, Tokyo, 143-8541 JAPAN

Accepted
May 25, 1999

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