Abstract
A case of giant duodenal cancer showing high serum AFP level, in which production of AFP was demonstrated by immunohistochemical staining is described.
A 53-year-old woman was admitted to the hospital because of right hypochondralgia. Serum AFP level on admission was 9210 ng/ml. The tumor was 14×12×8 cm in size and developed from the second portion of the duodenum partially over the pancreas head, pressing the gallbladder and right lobe of the liver, invading the transverse colon, uncus of the pancreas and superior mesenteric vein. However, there was no liver metastasis. Pancreatoduodenectomy and transverse colectomy were performed. Histological diagnosis was moderately differentiated tubular adenocarcinoma, and AFP was demonstrated by immunohistochemical staining with PAP method.
In Japan, duodenal cancer with high serum AFP level has been observed in only 8 patients including this, and in 6 patients of them the existence of AFP positive tumor cells was evidenced by immunohistochemical staining. Liver metastasis was positive in 5 patients. Prognosis of AFP producing cancer of the duodenum is very poor, so active resection and potent adjuvant chemotherapy would be important.
