Hepatoid adenocarcinoma of the stomach: an unusual case of elevated alpha-fetoprotein with prior treatment for hepatocellular carcinoma
Clinical and Molecular Hepatology
; : 173-178, 2013.
Article
in En
| WPRIM
| ID: wpr-25403
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ABSTRACT
Hepatoid adenocarcinoma (HAC) is a rare type of extrahepatic carcinoma whose morphology is similar to that of hepatocellular carcinoma (HCC). Metachronous HCC and HAC in the same patient is extremely rare. The case of a 68-year-old man with chronic hepatitis B infection who had both HCC and HAC of the stomach is reported herein. Nine years previously this patient had been diagnosed with HCC and received a right lobectomy. HCC that recurred at the caudate lobe at 6 months after the operation was successfully treated with transarterial chemoembolization. The patient was followed up regularly thereafter without evidence of tumor recurrence for 9 years. In July 2010 his serum alpha-fetoprotein (AFP) level elevated from 6.5 ng/mL to 625.4 ng/mL, and he developed a probable single metastatic lymph node around the hepatic artery without intrahepatic lesions. Subsequent evaluation with upper endoscopy revealed a 4-cm ulcerative lesion on the antrum of the stomach. Subtotal gastrectomy was performed with lymph-node dissection. Histologic examination revealed a special type of extrahepatic AFP-producing adenocarcinoma-HAC with lymph-node metastasis-which indicates that HAC can be a cause of elevated AFP even in patients with HCC. HAC should be considered if a patient with stable HCC exhibits unusual elevation of AFP.
Key words
Full text:
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Index:
WPRIM
Main subject:
Recurrence
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Stomach Neoplasms
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Titanium
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Camptothecin
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Adenocarcinoma
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Alpha-Fetoproteins
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Antineoplastic Combined Chemotherapy Protocols
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Tomography, X-Ray Computed
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Leucovorin
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Gastroscopy
Limits:
Aged
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Humans
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Male
Language:
En
Journal:
Clinical and Molecular Hepatology
Year:
2013
Type:
Article