Metachronous Liver Metastasis from Alpha-Fetoprotein-Producing Gastric Cancer Successfully Treated with Capecitabine/Oxaliplatin Combination Chemotherapy

A consensus regarding the treatment of recurrent alpha-fetoprotein-producing gastric carcinoma due to its rarity is lacking. We herein describe a case of such a carcinoma that was associated with metachronous liver metastasis. A 73-year-old man was referred for the surgical treatment of a type 2 gas...

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Bibliographic Details
Published in:Case reports in surgery 2022-08, Vol.2022, p.1-9
Main Authors: Furukawa, Soichi, Kobayashi, Takashi, Shiono, Saori, Nishinakagawa, Shuta
Format: Article
Language:English
Subjects:
Adenocarcinoma
Antigens
Blood tests
Cancer
Cancer therapies
Care and treatment
Case Report
Case reports
Chemotherapy
Drug therapy, Combination
Epidermal growth factor
Gastrectomy
Gastric cancer
Gastrointestinal surgery
Glycoproteins
Growth factors
Hepatectomy
Liver
Liver cancer
Lymph nodes
Lymphatic system
Magnetic resonance imaging
Medical prognosis
Metastases
Metastasis
Oxaliplatin
Stomach cancer
Tomography
Tumors
α-Fetoprotein
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Summary:A consensus regarding the treatment of recurrent alpha-fetoprotein-producing gastric carcinoma due to its rarity is lacking. We herein describe a case of such a carcinoma that was associated with metachronous liver metastasis. A 73-year-old man was referred for the surgical treatment of a type 2 gastric tumor that extended from the greater curvature of the gastric corpus to the pylorus. As no remote metastases were detected, the patient underwent open total gastrectomy with lymphadenectomy and Roux-en-Y reconstruction. Histopathological examination revealed regional lymph node metastasis and the invasion of the muscularis propria by a moderately differentiated adenocarcinoma. Immunostaining of the primary tumor was positive for alpha-fetoprotein and negative for human epidermal growth factor receptor 2. Serum alpha-fetoprotein levels decreased to within normal limits after eight courses of S-1 monotherapy; however, levels started to increase, and a hypovascular nodule in segment 5/6 of the liver was detected 3.5 years later. Serum alpha-fetoprotein levels returned to the normal range, and the tumor was undetectable after four courses of capecitabine and oxaliplatin therapy. No recurrence was detected at 1.5-year follow-up. This case demonstrates that combined capecitabine and oxaliplatin therapy can successfully treat metachronous liver metastasis from alpha-fetoprotein-producing gastric carcinoma.
ISSN:2090-6900
2090-6919
DOI:10.1155/2022/2700394