title: Spontaneous rupture of metastatic alpha-fetoprotein-producing gastric cancer of the liver.
abstract: An 80-year-old man was admitted to our hospital because of the rupture of the liver. Laboratory data showed iron-deficiency anemia, although there was no liver dysfunction. A computed tomography scan showed large liver tumor with intraperitoneal hemorrhage, and since a serum level of alpha-fetoprotein (AFP) was extremely high, we initially suspected a rupture of hepatocellular carcinoma (HCC). Transarterial embolization was performed to stop bleeding from the tumor, followed by an endoscopic examination that revealed advanced gastric cancer. Histological analysis revealed that both the gastric and the hepatic tumors were moderately to poorly differentiated adenocarcinoma, as well as that both tumors were immunohistochemically positive for AFP. Finally, we diagnosed AFP-producing gastric cancer associated with liver metastasis. Rupture of metastatic liver cancer is rare, and accordingly, distinction from HCC is important, particularly for the cases of AFP-producing gastric cancer.
authors: Department of Gastroenterology and Medicine, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan, tetsuro@fukuoka-u.ac.jp.
authors: Tetsuro
authors: T
authors: Sohda
authors: Takayuki
authors: T
authors: Hanano
authors: Hisanori
authors: H
authors: Miyamoto
authors: Yoko
authors: Y
authors: Kitano
authors: Kaoru
authors: K
authors: Iwata
authors: Masanori
authors: M
authors: Yokoyama
authors: Makoto
authors: M
authors: Irie
authors: Yasuaki
authors: Y
authors: Takeyama
authors: Satoshi
authors: S
authors: Shakado
authors: Shotaro
authors: S
authors: Sakisaka