title: AFP-producing hepatoid adenocarcinoma in association with Barrett's esophagus with multiple liver metastasis responding to paclitaxel/CDDP: a case report.
abstract: A case of alpha-fetoprotein (AFP)-producing hepatoid adenocarcinoma in association with Barrett's esophagus with multiple liver metastases, responding to chemotherapy, is reported. A 47-year-old man was admitted to our hospital with abdominal pain after subtotal esophagectomy for an esophageal adenocarcinoma in association with Barrett's esophagus, and was diagnosed as having multiple liver tumors. Most tumor markers were normal, but the serum AFP level was markedly elevated. Dynamic computed tomography and ferumoxide enhanced magnetic resonance imaging did not provide evidence of any primary hepatocellular carcinoma. Since microscopic examination of the resected tumor showed a poorly-differentiated adenocarcinoma with hepatoid features displaying AFP-immunoreactivity, the liver tumors were thus considered to be metastatic deposits. Surgery was not feasible so chemotherapeutic agents were tried, and the combination of paclitaxel (TXL) and cisplatin (CDDP) gave a partial response and good control for a period. This is the first report, to our knowledge, of effective chemotherapy for liver metastases from an AFP-producing hepatoid adenocarcinoma of the esophagus.
authors.affiliation: Department of Clinical Oncology, Institute of Development, Aging and Cancer (IDAC), Tohoku University Hospital, Tohoku University, Sendai, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Chiba
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Masato
authors.initials: M
authors.lastname: Sakayori
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Mikami
authors.forename: Mikami
authors.initials: M
authors.lastname: Yoshiki
authors.forename: Shukichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Shoko
authors.initials: S
authors.lastname: Akiyama
authors.forename: Kazunori
authors.initials: K
authors.lastname: Otsuka
authors.forename: Gengo
authors.initials: G
authors.lastname: Yamaura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shibata
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Kato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kato
authors.forename: Chikashi
authors.initials: C
authors.lastname: Ishioka
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000097:blood / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D000509:alpha-Fetoproteins / Q000096:biosynthesis*
chemical_list: D000509:alpha-Fetoproteins; D017239:Paclitaxel; D002945:Cisplatin