ALPHA-FETOPROTEIN, CARCINOEMBRYONIC ANTIGEN, AND CARBOHYDRATE ANTIGEN19-9-PRODUCING GALLBLADDER CANCER

We report a rare case of alpha-fetoprotein (AFP), carcinoembryonic ant igen (CEA), and carbohydrate antigen (CA) 19-9-producing gallbladder c ancer with high levels of CA125 and protein induced by vitamin K absen ce or antagonist II (PIVKA II). A 63-year-old man was diagnosed with g allbladder cancer with metastases to the liver, based on ultrasonograp hy and computed tomography of the abdomen showing multiple tumorous le sions in the liver and a thickened gallbladder wall. Laboratory data s howed high levels of tumor markers: 4647.4 ng/ml AFP, 9987.1 ng/ml CEA , 11 704.0 U/ml CA19-9, 847.6 U/ml CA125, and 0.2 AU/ml PIVKA II. AFP in the present case showed an increase in Concanavalin A-nonbinding fr action and an increase in Lens culinaris lectin-binding fraction by af finity column chromatography. The patient died of hepatic failure. Aut opsy revealed gallbladder cane er consisting of papillary adenocarcino ma and moderately differentiated tubular adenocarcinoma. By immunohist ochemical staining, AFP was detected in the papillary adenocarcinoma p ortion of the primary focus and metastatic tumor cells in the liver, b ut was not detected in noncancerous liver tissue. CEA and CA19-9 were detected mainly in the tubular adenocarcinoma portion.