A CASE OF ALPHA-FETOPROTEIN PRODUCING GASTRIC CANCER (PAPILLARY ADENOCARCINOMA) IN YOUNG ADULTS

Abstract

A 21-year-old female admitted with complaint of epigastric pain in December, 1991. Serum AFP level was elevated to 66.1 ng/ml (Table 1). X-ray and endoscopic examination (Figure 1, 2) showed Borrmann type 3 carcinoma which was located from the cardia to the lesser curvature of the upper body of the stomach. Liver metastasis was not detected by CT and ultrasonography. Total gastrectomy was performed. Spotty metastases were found on the surface of the liver in surgery. The resected specimen showed 7.2 x 5.3 cm in size, and it showed histologically papillary adenocarcinoma (Figure 5). Immunohistochemical studies showed that locations of AFP were found in the cancer cell stained by immunohistochemical method. Postoperative serum AFP level decreased to normal range transiently. There are a few case with papillary adenocarcinoma of the stomach in young adults under 30 years old. In Japan, only 6 cases including this one have been reported, and this is the first report of AFP producing papillary adenocarcinoma of the stomach in young adults.