Seronegative Alpha-Fetoprotein-Producing Early Gastric Cancer Treated with Endoscopic Mucosal Resection and Additional Surgery

• Published in: Internal Medicine Vol. 43; no. 10; pp. 926 - 930
• Main Authors: HIRASAKI, Shoji, TANIMIZU, Masahito, TSUZUKI, Takao, TSUBOUCHI, Eiji, HIDAKA, Satoshi, HYODO, Ichinosuke, TAJIRI, Hisao
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01-10-2004; Japanese Society of Internal Medicine
• Subjects: Aged; Alpha-fetoprotein; alpha-Fetoproteins - biosynthesis; Biological and medical sciences; early gastric carcinoma; Endoscopes, Gastrointestinal; Endoscopy, Gastrointestinal; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; immunohistochemistry; Japan; lymph node metastasis; Lymph Nodes - pathology; Lymph Nodes - surgery; Male; Medical sciences; Prognosis; Stomach - pathology; Stomach - surgery; Stomach Neoplasms - metabolism; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Treatment Outcome; Tumors; Japan; Immunohistochemistry; early gastric carcinoma; Resection; Mucosa; Malignant lymphadenopathy; Malignant tumor; α-Fetoprotein; Stomach cancer; Alpha-fetoprotein; Medicine; Stomach carcinoma; Anatomic pathology; Treatment; Surgery; Digestive diseases; Early; Endoscopy; Gastric disease; lymph node metastasis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.43.926

A 67-year-old man visited our hospital for the treatment of gastric carcinoma. Endoscopic mucosal resection was performed, however, histological examination of the resected specimen revealed tumor invasion to the submucosal layer with vessel invasion. Immunohistological studies were carried out on resected specimens and part of the cancerous lesion showed a positive reaction for alpha-fetoprotein (AFP), but the serum AFP level was normal. Additional distal gastrectomy with lymph node dissection revealed lymph node metastasis although there was no apparent finding of lymph node swelling by preoperative diagnostic imaging. This patient remains alive without disease for 3 years after surgery.