ALPHA-FETOPROTEIN-PRODUCING RECTAL-CANCER - CALCULATED TUMOR-MARKER DOUBLING TIME

Alpha-fetoprotein (AFP) production by rectal cancer is very rare. In t he English literature there are only a few reported cases in which ser um AFP level was > 1,000 ng/ml. A 43-year-old Japanese man with rectal cancer and liver metastases had a high serum AFP level (941 ng/ml) wh en first evaluated. Three weeks later, the serum AFP level was extreme ly elevated (7,060 ng/ml). He underwent abdominoperineal excision of t he rectum and biopsy of liver metastases. The placement of an intrahep atic-arterial infusion catheter into the proper hepatic artery via the right gastroepiploic artery was also performed. Immunohistochemically , AFP-positive cells were identified in both the rectal and liver tumo rs. Nine days postoperatively, the serum AFP level was 2,000 ng/ml. In spite of intensive chemoimmunotherapy, serum AFP level was increased and 14 weeks after surgery was extremely elevated (267,300 ng/ml). The patient succumbed to cancer 3 months after surgery. To our knowledge, this is the first case of an AFP-producing rectal cancer in which AFP doubling time could be calculated as 12.8 days. (C) 1994 Wiley-Liss, Inc.