Alpha-fetoprotein producing Barrett's esophageal adenocarcinoma: A case report

A 59-year-old man was admitted to our hospital with upper abdominal pain. H is serum alpha-fetoprotein (AFP) level was very high, 1500 ng/ml. Upper gas trointestinal endoscopy revealed depressed lesion at 36 cm from the upper i ncisors, with columnar epithelium lining the esophagus circumferentially to the oral side of the lesion. Histological examination of biopsy specimens revealed a tubular adenocarcinoma as well as the presence of gastric column ar epithelium with intestinal metaplasia. Immunohistochemistry demonstrated AFP in the tumor cells. From these results, a diagnosis of AFP-producing e sophageal adenocarcinoma occurring in Barrett's esophagus, a condition whic h is extremely rare in Japan, was established. Computed tomography (CT) sho wed multiple metastasis on the liver and wide-ranging lymph none metastasis . Chemotherapy was not effective and the patient died about 2 months after the start of treatment. The AFP-producing esophageal adenocarcinoma present ed here had biological characteristics similar to those of AFP-producing ga stric cancer.