title: Misdiagnosis of an α-fetoprotein-producing esophageal carcinoma: A case report and literature review.
abstract: α-fetoprotein (AFP)-producing esophageal carcinoma is a rare type of esophageal cancer, with its characteristics not yet fully clarified. In the present study, a case of esophageal carcinoma was misdiagnosed as an AFP-producing esophageal carcinoma. The patient was a 50-year-old woman who was referred to Qianfoshan Hospital Affiliated to Shandong University in November 2014 with a 3-month history of progressive dysphagia. A chest computed tomography (CT) scan showed thickening of the wall of the esophagus, corresponding regions of luminal stenosis and massive lymph node swelling around the lesser curvature of the esophagus. A laboratory investigation showed that the serum AFP levels of the patient were elevated to 18.97 ng/ml (normal range <12 ng/ml). These laboratory investigation findings combined with the aforementioned pathological diagnosis supported a diagnosis of AFP-producing esophageal carcinoma. An abdominal ultrasound was performed and a cystic low-density measuring 5×4 mm was identified. No metastases were revealed in the liver. The boundary of the focal low density was clear, which indicated a clinical diagnosis of liver cyst. A radical esophagectomy was performed on December 5, 2014. Microscopically, the tumor was a moderately differentiated squamous cell carcinoma invading the serous layer, with no hepatoid features. Immunohistochemistry showed that the cells were diffusely negative for AFP expression. Histopathological examination revealed the absence of hepatoid features. According to these findings, the tumor was diagnosed as a moderately differentiated squamous cell carcinoma. In the present study, the case of a patient with squamous cell carcinoma that was misdiagnosed as an α-fetoprotein-producing esophageal carcinoma was reported, with a review of the literature.
authors.affiliation: Department of Thoracic Surgery, Shengli Oilfield Central Hospital, Dongying, Shandong 257034, P.R. China.
authors.forename: Ningbo
authors.initials: N
authors.lastname: Sun
authors.affiliation: Division of Surgery, Graduate Department, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, P.R. China.
authors.forename: Xunlu
authors.initials: X
authors.lastname: Yin
authors.affiliation: Department of Burns and Orthopedics, The First Hospital of Lianyungang, Lianyungang, Jiangsu 222002, P.R. China.
authors.forename: Yuren
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: Department of Thoracic Surgery, Dezhou People's Hospital, Dezhou, Shandong 253014, P.R. China.
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Thoracic Surgery, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, P.R. China.
authors.forename: Xiangfang
authors.initials: X
authors.lastname: Meng
authors.affiliation: Department of Thoracic Surgery, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, P.R. China.
authors.forename: Q I
authors.initials: QI
authors.lastname: Zang
keywords: AFP-producing esophageal cancer; esophageal cancer; radical esophagectomy; α-fetoprotein