title: Elevated serum alpha-fetoprotein in poorly differentiated adenocarcinoma with neuroendocrine differentiation of the ascending colon: a case report.
abstract: BACKGROUND
  Colorectal cancer (CRC) is the most common form of cancer and the third leading cause of death in Taiwan. Serum alpha-fetoprotein (AFP) has been extensively used as a biomarker for hepatocellular carcinoma (HCC) and yolk sac tumors.
  
  
  METHODS
  This case report presents a 90-year-old woman with right abdominal pain and poor appetite for 1 week. The computed tomography (CT) showed wall thickening in the proximal ascending colon with ruptured appendicitis. Preoperative serum AFP was high. There was no definite liver metastasis or other abnormal findings in the hepatobiliary systems. After initial empirical antibiotic treatment, we performed laparoscopic right hemicolectomy. The pathological assessment was poorly differentiated adenocarcinoma with neuroendocrine differentiation in the ascending colon. The tumor cells did not produce AFP. Amazingly, the follow-up serum AFP level 1 month after the surgery declined to normal range. The patient had an uneventful course after the surgery and was free of recurrence or metastasis within 5 months of follow-up.
  
  
  CONCLUSIONS
  AFP may be a useful tumor marker in poorly differentiated colorectal cancer with neuroendocrine component patients and a prediction of early treatment response.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11221, Taiwan.
authors.forename: Hung-Hsin
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Taipei City, 11696, Taiwan.
authors.forename: Chia-Chu
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan.
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan.
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan.
authors.forename: Wei-Shone
authors.initials: WS
authors.lastname: Chen
authors.affiliation: Department of Pathology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan.
authors.forename: Wen-Yih
authors.initials: WY
authors.lastname: Liang
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan.
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei City, 11217, Taiwan. jkjiang@vghtpe.gov.tw.
authors.forename: Jeng-Kai
authors.initials: JK
authors.lastname: Jiang
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000601:surgery; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018278:Carcinoma, Neuroendocrine / Q000097:blood / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D044682:Colon, Ascending / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins
keywords: Adenocarcinoma; Alpha-fetoprotein; Colon cancer; Neuroendocrine; Poorly differentiated