A case of AFP-producing early gastric carcinoma with rapid growth liver metastasis

An 84-year-old man presented with complaints of epigastric discomfort. Uppe r gastrointestinal series and endoscopy showed an elevated lesion at the po sterior wall of greater curvature on the gastric fundus. Diagnosed as moder ately differentiated tubular adenocarcinoma by biopsy, wedge resection and 4sa regional lymph node dissection were carried out. The tumor morphology s howed type I with slight elevation, 2.5x1.7cm in size; histological showed papillary, tubular, and solid formations having clear cytoplasm and large b izarre nuclei invading the deep submucosal layer (sm2). This case was evalu ated as T1(sm) NO MO stage la early gastric cancer. In the 5th month after operation, multiple liver metastases were detected. He died of liver failur e by rapid growth of metastatic tumors in the 6th month after operation. Th e serum alpha-fetoprotein level at recurrence was 1,900ng/mL, and alpha-fet oprotein-positive cells were inimunohistochemically detected in operative a nd liver biopsy specimens.