Since the epochmaking report of the Tatarinov's in 1964, α-fetoprotein in the adults has been detected almost exclusively in cases with the hepatoma. Evidences, however, have accumulated that the metastatic carcinoma to the liver also can induce the production of α-fetoprotein in rare cases.
The present paper reports a case of gastric carcinoma, Borrmann type III, with metastasis to the liver exhibiting a remarkably high concentration of serum α-fetoprotein.
A 64-year-old Japanese female was admitted to Keio University Hospital in Octover 1971, because of tarry stool. Fluoroscopic examination and gastrocamera revealed a Borrmann type III of gastric carcinoma at the antrum, which was found histologically to be adenocarcinoma tubulare. α-fetoprotein, up to 384mg/dl in the serum at one time, was detected to decrease remarkably following the application of the carcinostatic substances. The patient went downhill course and expired in January, 1972.
The post-mortem examination revealed the carcinoma of the stomach with metastasis to the liver, pancreas, and perigastric lymph nodes. The metastatic tumor nodules in the liver measured up to 4cm in diameter.
The tissue extracts of a portion of the tumor nodule in the liver and that of the liver tissue surrounding the tumor contained α-fetoprotein, 48ng/ml and 43ng/ml each. This suggests the possibility that α-fetoprotein can be produced by the metastatic carcinoma to the liver as well non-tumorous liver tissue.
38 cases of metastatic gastric carcinoma to the liver with positive α-fetoprotein have been reported in Japan. It is, however, interesting that this case showed the very high value of serum α-fetoprotein.
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