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Case Reports
. 2013 Feb;29(2):106-10.
doi: 10.1016/j.kjms.2012.08.018. Epub 2012 Oct 22.

A case of alpha-fetoprotein-producing esophageal adenocarcinoma

Yi-Yu Chen  1 , Wen-Hung Hsu, Huang-Ming Hu, Deng-Chyang Wu, Wen-Yi Lin
Affiliations
Case Reports

A case of alpha-fetoprotein-producing esophageal adenocarcinoma

Yi-Yu Chen et al. Kaohsiung J Med Sci. 2013 Feb.

Abstract

Alpha-fetoprotein is a well-known tumor marker in the screening and follow-up of hepatocellular carcinoma. In Taiwanese society, a high prevalence of hepatitis and hepatoma and elevation of alpha-fetoprotein associated with liver function impairment usually suggested clinics undertake further examination for liver or genital tumor. We report the case of 45-year-old man who was found to have an alpha-fetoprotein-producing esophageal adenocarcinoma with an initial presentation of liver function impairment and rapid elevation of alpha-fetoprotein. Esophageal cancer was diagnosed via endoscope and a biopsy proved the presence of adenocarcinoma. A small endoscopic biopsy specimen failed to identify the alpha-fetoprotein positive tumor cell. Esophagectomy was performed and histopathological study of surgical specimen revealed grade II adenocarcinoma with regional metastatic lymphadenopathy. Immunohistochemical study was focal positive for alpha-fetoprotein. Serum alpha-fetoprotein declined transiently after esophagectomy and fluctuation of alpha-fetoprotein level was noted during the treatment with adjuvant chemotherapy. Finally, 19 months after the operation, the patient died due to multiple organ metastases with multiple organ failure. Thus, a small specimen for upper endoscopy may not be sufficient in the presence of alpha-fetoprotein-producing adenocarcinoma. Monitoring of serum alpha-fetoprotein may be useful in the evaluation and follow-up of esophageal alpha-fetoprotein-producing adenocarcinoma.

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Figures

Figure 1
Figure 1
Barium esophagogram showed a polypoid filling defect in the distal esophagus and central depression was noted (arrow). Mild contour irregularity and rigidity was also identified at the esophagus–cardiac junction.
Figure 2
Figure 2
Upper endoscopy showed a polypoid lesion with fragility in the lower third of the esophagus. Mild lumen narrowing was also noted.
Figure 3
Figure 3
Abdominal computed tomography revealed annular wall thickening with a blurred adventitia margin in the lower esophagus and the soft tissue mass lesion was downward to the cardiac portion. Metastatic lymphadenopathy was noted (arrow).
Figure 4
Figure 4
Histological appearance of the surgical specimen from the esophageal caner showed tubular adenocarcinoma. Immunochemistry stain with alpha‐fetoprotein was focal positive with alpha‐fetoprotein in cytoplasm (arrows).
Figure 5
Figure 5
The alpha‐fetoprotein level dropped immediately after esophagectomy (arrow). It increased again with tumor recurrence.
See this image and copyright information in PMC

References

    1. Ciftci A.O., Bingol‐Kologlu M., Senocak M.E., Tanyel F.C., Buyukpamukcu M., Buyukpamukcu N.. Testicular tumors in children. J Pediatr Surg. 2001; 36: 1796–1801. - PubMed
    1. Huang H.Y., Ko S.F., Chuang J.H., Jeng Y.M., Sung M.T., Chen W.J.. Primary yolk sac tumor of the urachus. Arch Pathol Lab Med. 2002; 126: 1106–1109. - PubMed
    1. Lopez‐Beltran A., Luque R.J., Quintero A., Requena M.J., Montironi R.. Hepatoid adenocarcinoma of the urinary bladder. Virchows Arch. 2003; 442: 381–387. - PubMed
    1. Michielsen P.P., Francque S.M., van Dongen J.L.. Viral hepatitis and hepatocellular carcinoma. World J Surg Oncol. 2005; 3: 27. - PMC - PubMed
    1. Nakashima H., Nagafuchi K., Satoh H., Takeda K., Yamasaki T., Yonemasu H., et al. Hepatoid adenocarcinoma of the gallbladder. J Hepatobiliary Pancreat Surg. 2000; 7: 226–230. - PubMed

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