ALPHA-FETOPROTEIN-PRODUCING EARLY GASTRIC-CANCER ACCOMPANYING LIVER-CIRRHOSIS - A CASE-REPORT

A rare case of alpha-fetoprotein (AFP)-producing early gastric cancer with liver cirrhosis is presented. A 61-year-old man was admitted to S himane Medical University Hospital in 1988 because of abnormal liver f unction test results suggestive of liver cirrhosis with mild elevation of AFP. Liver cirrhosis was confirmed laparoscopically and histologic ally. Gastric cancer was found in fluoroscopic and endoscopic studies. After partial gastrectomy, the serum AFP level fluctuated transiently within normal limits, and then gradually increased soon after the ope ration. Therefore, complication of hepatocellular carcinoma was suspec ted, but no tumor in the liver was detected by any imaging examination , including angiography. Two years after the operation, swelling of ab dominal periaortic lymph nodes was noted at a periodic check-up, but s till no hepatic tumor was found. At this point, AFP-producing gastric cancer was suspected, and an AFP staining test was carried out on the tissue of the resected specimen. AFP-positive cells were recognized im munohistochemically. Thus, we diagnosed the condition as post-operativ e recurrence of an AFP-producing gastric cancer accompanying liver cir rhosis.