Serum alpha-fetoprotein-positive gastric carcinoid with liver metastasis

The patient was a 60-year-old Japanese male. He complained of epigastralgia and right chest pain of 4 month's duration, and general malaise, nausea and vomiting of 2 month's duration. Physical examination revealed on the right third rib a tender mass with a diameter of 2 cm and hepatomegal...

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Bibliographic Details
Published in:Virchows Archiv A Pathological Anatomy and Histology 1980-01, Vol.387 (1), p.107-116
Main Authors: Mori, H, Onji, M, Yoshida, A, Fukunishi, R
Format: Article
Language:English
Subjects:
alpha-Fetoproteins - analysis
Autopsy
Carcinoembryonic Antigen - analysis
Carcinoid Tumor - pathology
Carcinoid Tumor - secondary
Humans
Liver Neoplasms - pathology
Liver Neoplasms - secondary
Male
Middle Aged
Stomach Neoplasms - pathology
Uremia - complications
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Summary:The patient was a 60-year-old Japanese male. He complained of epigastralgia and right chest pain of 4 month's duration, and general malaise, nausea and vomiting of 2 month's duration. Physical examination revealed on the right third rib a tender mass with a diameter of 2 cm and hepatomegaly with a multi-nodular surface and red palms. There were no signs of carcinoid syndrome, such as cutaneous flushing. Laboratory examinations disclosed certain biochemical alterations; alkaline phosphatase 810 IU/l, gamma-glutamyl transpeptidase (gamma-GTP) 2090 IU/l, carcinoembryonic antigen (CEA) 23.5 ng/ml and alpha-fetoprotein (AFP) 6,800 ng/ml. Both HBs-Ag and HBs-Ab were negative. The patient died in a uremic state, with rapid increases of jaundice and ascites. Autopsy revealed gastric carcinoid with extensive metastases to the liver and the bone marrow. Tumor cells showed argyrophilia but not argentaffinity. Immunofluorescence specific for AFP was positive in the hepatocytes, particularly those adjacent to the metastatic tumor cells but not in the tumor cells, either primary or secondary. 79 cases reported in Japan of serum AFP-positive malignant tumor other than hepatocellular carcinoma and certain other malignancies of germ cell origin are reviewed and discussed.
ISSN:0340-1227
1432-2307
DOI:10.1007/BF00428433