A Case of Gallbladder Carcinoma Producing Alpha-Fetoprotein which was Difficult to Make Differential Diagnosis from Hepatocellular Carcinoma

Tadafumi Asaoka, Motoi Kondo¹⁾, Hiroaki Nagano, Hiroyuki Hanada²⁾, Masato Sakon, Keizo Dono, Koji Umeshita, Shoji Nakamori, Ken-ichi Wakasa³⁾ and Morito Monden

Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University
Department of Surgery, Sakai Municipal Hospital¹⁾
Laboratory for Clinical Investigation, Osaka University Hospital²⁾
Department of Pathology, Osaka City University Hospital³⁾

A 49-year-old woman admitted for general fatigue and right hypochondralgia was found in. Preoperative CT to have a relative hypervascular tumor in the gallbladder fossa. MRI showed low intensity in T1 and high intensity in T2 imaging. Tumor marker test showed high AFP-L3. She underwent surgery under a preoperative diagnosis of HCC or mixed HCC, but was diagnosed intraoperatively as gallbladder carcinoma, necessitating radical resection with regional lymph node dissection. The analysis of lectin affinity electrophoresis of AFP showed AFP-L2 and AFP-L3 bands, suggesting non hepatoma malignancy. We concluded that gallbladder carcinoma should be considered if we observe AFP-producing liver tumors next to the gallbladder. Lectin affinity electrophoresis of AFP is thus helpful in differentiation between HCC and AFP-producing gallbladder carcinoma.

Key words
AFP-L2, AFP-L3, gallbladder carcinoma

Reprint requests
Hiroaki Nagano Department of Surgery, Osaka University Graduate School of Medicine
E-2, 2-2 Yamadaoka, Suita, 565-0871 JAPAN

Accepted
January 26, 2005

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