title: Des-gamma-carboxy prothrombin (PIVKA-II)-producing mediastinal embryonal carcinoma with features of hepatoid differentiation.
abstract: The case of a 48-year-old man with primary nonseminomatous embryonal carcinoma at the posterior mediastinum is described. The patient displayed extremely high plasma levels of Des-gamma-carboxy prothrombin (PIVKA-II) (4040 mAU/ml). Ultrasonography and dynamic computed tomography ruled out hepatocellular carcinoma (HCC) or liver metastasis. After preoperative systemic chemotherapy, total tumor resection was performed. Postoperatively, the plasma levels of PIVKA-II returned to within the normal range (24 mAU/ml). An immnohistochemical study using anti-PIVKA-II monoclonal antibody revealed the cytoplasmic expression of PIVK4-II in the carcinoma cells. These results indicate that tumor cells, which are manifested as hepatoid differentiation, may produce PIVKA-II. This case seems to be the first case reported in which PIVKA-II was produced by nonseminomatous mediastinal embryonal carcinoma without HCC or liver metastasis.
authors.affiliation: Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Tomita
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shigeoka
authors.forename: Masanari
authors.initials: M
authors.lastname: Watanabe
authors.forename: Akira
authors.initials: A
authors.lastname: Yamasaki
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
mesh_terms: D015415:Biomarkers / Q000097:blood*; D018236:Carcinoma, Embryonal / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D002454:Cell Differentiation / Q000502:physiology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D008297:Male; D008479:Mediastinal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin