title: Gastrointestinal Obstruction due to Solitary Lymph Node Recurrence of Alpha-Fetoprotein-Producing Gastric Carcinoma with Enteroblastic Differentiation.
abstract: We report an unusual case of alpha-fetoprotein (AFP)-producing gastric carcinoma with enteroblastic differentiation. A 75-year-old woman was admitted to our hospital with occasional upper abdominal discomfort. We performed gastroscopy and observed a type 2 tumor, primarily in the pyloric region. Histological examination of biopsies confirmed gastric adenocarcinoma. Based on these findings, we diagnosed gastric adenocarcinoma and performed laparoscopic distal gastrectomy with lymph node dissection. Histological examination revealed an invasive lesion composed of adenocarcinoma with a tubulopapillary growth pattern. Tumor cells were cuboidal in shape with characteristically clear cytoplasm rich in glycogen. Two regional lymph node metastases were seen microscopically. Immunohistochemically these cells were positive for AFP, carcinoembryonic antigen, caudal-type homeobox transcription factor 2 and common acute lymphoblastic leukemia antigen. The final diagnosis was AFP-producing gastric carcinoma with enteroblastic differentiation. 26 months after initial surgery, the patient was readmitted to our hospital for gastrointestinal obstruction due to lymph node recurrence.
authors.affiliation: Department of Surgery, Kushiro Red Cross Hospital, Kushiro, Sapporo, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamabuki
authors.affiliation: Department of Surgery, Kushiro Red Cross Hospital, Kushiro, Sapporo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Omi
authors.affiliation: Department of Surgery, Kushiro Red Cross Hospital, Kushiro, Sapporo, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Yonemori
authors.affiliation: Department of Surgery, Kushiro Red Cross Hospital, Kushiro, Sapporo, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Misu
authors.affiliation: Department of Surgery, Kushiro Red Cross Hospital, Kushiro, Sapporo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inomata
authors.affiliation: Department of Pathology, Sapporo General Pathology Laboratory, Sapporo, Japan.
authors.forename: Yukie
authors.initials: Y
authors.lastname: Abiko
authors.affiliation: Department of Pathology, Sapporo General Pathology Laboratory, Sapporo, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Surgery, Kushiro Red Cross Hospital, Kushiro, Sapporo, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nihei
keywords: Alpha-fetoprotein-producing gastric carcinoma; Gastrointestinal obstruction; Lymph node recurrence