title: [A case of alpha-fetoprotein-producing recurrent lung adenocarcinoma successfully treated with radiation therapy(high-grade adenocarcinoma of fetal lung type)].
abstract: A 71-year-old woman with a high serum α-fetoprotein (AFP) level was closely examined systemically, and a solid nodule was identified in the right middle lobe of her lung by chest computed tomography. As this lesion was highly suspected to be primary lung cancer, right middle lobectomy was performed via hybrid video-assisted thoracic surgery. According to histopathological examination, this lesion consisted of papillary adenocarcinoma and well-differentiated fetal adenocarcinoma (WDFA). In addition, the component of WDFA was positive for AFP, according to immunohistochemical staining. The lesion was eventually diagnosed as AFP-producing primary lung adenocarcinoma, pT2aN2M0, pStage IIIA. The serum AFP level was promptly normalized after surgery. Three courses of adjuvant chemotherapy were administered, but her serum AFP level gradually increased. Thereafter, local recurrence was recognized at the mediastinum 5 months after surgery. Conventional irradiation was delivered to the ipsilateral hilum and mediastinum. Consequently, the metastatic lesion in the mediastinal lymph node was completely eradicated, and her serum AFP level decreased to normal limits. Currently, the patient is alive without local relapse for 23 months after surgery. It is believed that radiation therapy might be an effective treatment option for AFP-producing primary lung adenocarcinoma.
authors.affiliation: Dept. of Surgery, Sakai City Hospital, Japan.
authors.forename: Haruna
authors.initials: H
authors.lastname: Furukawa
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Oda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nishie
authors.forename: Kotaro
authors.initials: K
authors.lastname: Miyake
authors.forename: Kayo
authors.initials: K
authors.lastname: Ota
authors.forename: Koji
authors.initials: K
authors.lastname: Nishida
authors.forename: Tetsu
authors.initials: T
authors.lastname: Munakata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikeda
authors.forename: Koichi
authors.initials: K
authors.lastname: Onaru
authors.forename: Iwao
authors.initials: I
authors.lastname: Goma
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012008:Recurrence; D000509:alpha-Fetoproteins / Q000096:biosynthesis
chemical_list: D000509:alpha-Fetoproteins