A CASE OF AFP PRODUCING GASTRIC CANCER WITH DIFFERENT HISTOLOGICAL FEATURE IN THE PRIMARY AND THE METASTATIC LESIONS

Abstract

An 82-year-old woman was admitted to the hospital because of a gastric cancer in the antrum. Distal gastrectomy was uneventfully performed. Preoperative serum AFP and CA 19-9 levels were as high as 1100ng/ml and 220U/ml, respectively. Histopathologically, the primary lesion was classified as moderately to poorly (solid type) differentiated adenocarcinoma, and the metastatic lymph nodes as poorly (solid type) differentiated adenocarcinoma. Immunohistochemically, AFP positive cancer cells were detected in some parts of tube2 of the primary lesion, and in major parts of porl of the metastatic lymph nodes. CA19-9 positive cancer cells were detected in both the primary lesion and the metastatic lymph nodes extensively. An AFP producing gastric cancer with different histological feature in the primary and the metastatic lesions is considered to be rare, and this case is highly suggestive in relation to multiple differentiation of AFP producing gastric cancer.