A case of alpha-fetoprotein producing gastric cancer with liver metastasis obtained long term survival

A 59-year-old Japanese man underwent gastrectomy for gastric cancer. Histological. findings, which showed poorly differentiated adenocarcinoma with solid tubular and trabecular structure, and multiple differentiation demonstrated by immunohistochemical positivity for alpha-fetoprotein (AFP), CEA and CA19-9, led to a diagnosis of hepatoid adenocarcinoma. 6 months after operation, a serum level of AFP was increased (30 ng/ml), and liver metastases were detected. Histology of resected metastatic foci was same as that of the stomach. Transarterial infusion chemotherapy has been done for 3 years. AFP producing gastric cancer, especially hepatoid adenocarcinoma with liver metastasis has quite poor prognosis. But this patient is alive with no recurrence for 8 years after surgery. The expression of a cell cycle marker(histone H3 mRNA) that might be used for a prognostic factor was low frequent.