Successful Surgical Resection of Synchronous Liver Metastasis with Portal Tumor Thrombus from Alpha-Fetoprotein-Producing Gastric Cancer without Recurrence more than 5 Years after Surgery: Report of a Case

Masaki Azuma, Shohachi Suzuki, Takanori Sakaguchi, Shigeyasu Ota, Keisuke Inaba, Satoshi Baba*, Hiroyuki Konno and Satoshi Nakamura

Second Department of Surgery, Hamamatsu University School of Medicine
Department of Clinical Pathology, Fukuroi Municipal Hospital*

We report a 67-year-old man with alpha-fetoprotein (AFP)-producing gastric cancer and synchronous liver metastasis with a portal tumor thrombus. After being followed up elsewhere for hepatitis C virus infection, he was admitted in August 1999 for a liver tumor found due to high serum AFP. Abdominal CT showed a 7.5 cm-diameter tumor developing into a portal branch in the right hepatic lobe. Gastrointestinal fiberscopy showed a type 2 tumor in the remnant stomach, histologically diagnosed as poorly differentiated adenocarcinoma. We diagnosed lesions as hepatocellular carcinoma and gastric cancer in the remnant stomach. Three weeks after percutaneous transhepatic portal embolization, we conducted extended right hepatic lobectomy and partial gastric resection. Since both hepatic and gastric tumors were positive for AFP immunohistochemical staining, we diagnosed him histologically as having AFP-producing gastric cancer with liver metastasis. He underwent adjuvant chemotherapy with 5-FU and CDDP and is doing well without recurrence more than 5 years after surgery.

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

Reprint requests
Masaki Azuma Second Department of Surgery, Hamamatsu University School of Medicine
1-20-1 Handayama, Hamamatsu, 431-3192 JAPAN

Accepted
February 23, 2005

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