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. 2008 Jun;2(2):258-61.
doi: 10.1007/s12072-008-9072-3. Epub 2008 Apr 8.

Spontaneous rupture of metastatic alpha-fetoprotein-producing gastric cancer of the liver

Tetsuro Sohda  1 , Takayuki Hanano, Hisanori Miyamoto, Yoko Kitano, Kaoru Iwata, Masanori Yokoyama, Makoto Irie, Yasuaki Takeyama, Satoshi Shakado, Shotaro Sakisaka
Affiliations

Spontaneous rupture of metastatic alpha-fetoprotein-producing gastric cancer of the liver

Tetsuro Sohda et al. Hepatol Int. 2008 Jun.

Erratum in

  • Errata.
    Omata M, Sarin SK. Omata M, et al. Hepatol Int. 2008 Sep;2(3):395-6. doi: 10.1007/s12072-008-9089-7. Hepatol Int. 2008. PMID: 19669272 Free PMC article. No abstract available.

Abstract

An 80-year-old man was admitted to our hospital because of the rupture of the liver. Laboratory data showed iron-deficiency anemia, although there was no liver dysfunction. A computed tomography scan showed large liver tumor with intraperitoneal hemorrhage, and since a serum level of alpha-fetoprotein (AFP) was extremely high, we initially suspected a rupture of hepatocellular carcinoma (HCC). Transarterial embolization was performed to stop bleeding from the tumor, followed by an endoscopic examination that revealed advanced gastric cancer. Histological analysis revealed that both the gastric and the hepatic tumors were moderately to poorly differentiated adenocarcinoma, as well as that both tumors were immunohistochemically positive for AFP. Finally, we diagnosed AFP-producing gastric cancer associated with liver metastasis. Rupture of metastatic liver cancer is rare, and accordingly, distinction from HCC is important, particularly for the cases of AFP-producing gastric cancer.

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Figures

Fig. 1
Fig. 1
A computed tomography scan showing large tumor in the right lobe of the liver and fluid collection within the tumor
Fig. 2
Fig. 2
Emergency angiography revealing a huge hypervascular tumor in segment 6 of the liver (arrow heads). Transarterial embolization was immediately performed to control the bleeding from the tumor
Fig. 3
Fig. 3
Endoscopic examination, performed on the following day, showing Borrmann III type advanced cancer at the cardiac region of the stomach
Fig. 4
Fig. 4
(a) Gastric tumor showing moderately differentiated adenocarcinoma. (b) The findings of the liver tumor resembled that of the gastric lesion. Both (c) the gastric and (d) the liver lesions were positive for AFP immunohistochemically
See this image and copyright information in PMC

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