title: Alpha-fetoprotein producing Barrett's esophageal adenocarcinoma: a case report.
abstract: A 59-year-old man was admitted to our hospital with upper abdominal pain. His serum alpha-fetoprotein (AFP) level was very high, 1500 ng/ml. Upper gastrointestinal endoscopy revealed depressed lesion at 36 cm from the upper incisors, with columnar epithelium lining the esophagus circumferentially to the oral side of the lesion. Histological examination of biopsy specimens revealed a tubular adenocarcinoma as well as the presence of gastric columnar epithelium with intestinal metaplasia. Immunohistochemistry demonstrated AFP in the tumor cells. From these results, a diagnosis of AFP-producing esophageal adenocarcinoma occurring in Barrett's esophagus, a condition which is extremely rare in Japan, was established. Computed tomography (CT) showed multiple metastasis on the liver and wide-ranging lymph node metastasis. Chemotherapy was not effective and the patient died about 2 months after the start of treatment. The AFP-producing esophageal adenocarcinoma presented here had biological characteristics similar to those of AFP-producing gastric cancer.
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Daini Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shimakawa
authors.forename: K
authors.initials: K
authors.lastname: Ogawa
authors.forename: Y
authors.initials: Y
authors.lastname: Naritaka
authors.forename: Y
authors.initials: Y
authors.lastname: Wagatsuma
authors.forename: T
authors.initials: T
authors.lastname: Katsube
authors.forename: K
authors.initials: K
authors.lastname: Hamaguchi
authors.forename: S
authors.initials: S
authors.lastname: Konno
authors.forename: M
authors.initials: M
authors.lastname: Aiba
authors.forename: T
authors.initials: T
authors.lastname: Kajiwara
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D004938:Esophageal Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D000509:alpha-Fetoproteins / Q000096:biosynthesis*
chemical_list: D000509:alpha-Fetoproteins