A Long Survival Case of Brain Metastases from AFP Producing Gastric Cancer

Junya Noguchi, Koutarou Kitahara, Kazutoshi Date, Kazuyuki Ono and Makoto Kawaguchi*

Department of Surgery and Pathology*, Niigata Rousai Hospital

A 75-year old male was admitted to our hospital after being diagnosed as having gastric cancer. Tests upon hospitalization revealed high CEA (132 ng/ml) and AFP (75.3 ng/ml) values. In January 1997 pylorogastrectomy was performed. The case was classified as gastric cancer producing AFP tub1, SS, ly2, v1, N1, and Stage II. The patient began to develop a headache about 1 year 4 months after surgery, whereupon he was diagnosed as having brain metastasis from the same gastric cancer. Tumorectomy was performed. Metastatic gastric cancer and AFP production were also confirmed pathologically. About five years since surgery, the patient is still alive without recurrence. Both gastric cancer producing AFP and brain metastasis from gastric cancer generally have poor prognosis. In the present case it was possible to select surgical treatment and obtain a good prognosis. Surgical treatment could be one mode of treatment also for cases of brain metastasis from gastric cancer producing AFP. ATBF1, a transcription factor involved in AFP production inhibition, was not expressed at the tumor site where AFP production was seen also in the present case. This enabled confirmation of one of the features of gastric cancer producing AFP.

Key words
AFP-producing gastric cancer, brain metastases, ATBF1

Reprint requests
Junya Noguchi Department of Kirishimaonsen Rousai Hospital
2607-189 Taguchi, Kirishima-chou, Aira-gun, Kagoshima, 899-4201 JAPAN

Accepted
June 25, 2003

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