Abstract
A 75-year-old man underwent a lobectomy for primary lung cancer which was associated with an abnormally elevated serum alpha-fetoprotein (AFP) level of 3, 871ng/ml. The serum AFP level declined to the normal range soon after the operation. Cancer recurrence in the contralateral lung was detected by follow-up chest X-ray and CT 6 months after surgery, although the serum AFP level remained normal. There was no further recurrence, after a second operation was performed in which the recurrent lesions were completely resected.
Pathological examination of these lesions revealed poorly differentiated adenocarcinoma, as at the primary site. Immunohistochemical staining confirmed AFP in cancer cells, however, the number of AFP-positive cells in the recurrent lesions was much greater than in the primary lesion. At 10 months after the second surgery, the patient remains alive without further recurrence. This case suggests that monitoring serum AFP is not necessarily useful for predicting the recurrence of AFP-producing lung cancer, and that systemic radiological examination, including computed tomography, is more appropriate to detect recurrence.
