A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer

Abstract Background Alpha-fetoprotein-producing gastric cancer (AFP-GC) is a relatively rare disease, with a dismal prognosis. Case presentation We report the case of a patient with long-term survival after surgery for the recurrence of AFP-GC. A 71-year-old man was diagnosed with gastric cancer and...

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Main Authors: Manabu Harada, Hironori Tsujimoto, Takashi Ichikura, Hiromi Nagata, Nozomi Ito, Shinsuke Nomura, Hiroyuki Horiguchi, Yoshihisa Yaguchi, Yoji Kishi, Hideki Ueno
Format: Article
Language:English
Published: Japan Surgical Society 2019-07-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-019-0664-z
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author Manabu Harada
Hironori Tsujimoto
Takashi Ichikura
Hiromi Nagata
Nozomi Ito
Shinsuke Nomura
Hiroyuki Horiguchi
Yoshihisa Yaguchi
Yoji Kishi
Hideki Ueno
author_facet Manabu Harada
Hironori Tsujimoto
Takashi Ichikura
Hiromi Nagata
Nozomi Ito
Shinsuke Nomura
Hiroyuki Horiguchi
Yoshihisa Yaguchi
Yoji Kishi
Hideki Ueno
author_sort Manabu Harada
collection DOAJ
description Abstract Background Alpha-fetoprotein-producing gastric cancer (AFP-GC) is a relatively rare disease, with a dismal prognosis. Case presentation We report the case of a patient with long-term survival after surgery for the recurrence of AFP-GC. A 71-year-old man was diagnosed with gastric cancer and underwent distal gastrectomy with D2 lymphadenectomy (pT3N2M0). Pathological examination of the resected specimen revealed AFP-GC. Fifteen years after the gastrectomy, the patient experienced anorexia and was admitted with a mass located at the mesentery of the small intestine. Following a diagnosis of gastrointestinal stromal tumor of the mesentery, a tumor resection with partial small intestine was performed. The final histopathological diagnosis was AFP-GC’s recurrence in the small-bowel mesentery. Two months later, multiple liver metastases were identified, and serum AFP level was found to be extremely high (17,447 ng/mL). Chemotherapy with S-1+CDDP (SP) was initiated for liver metastasis. However, owing to anorexia and fatigue, SP therapy was discontinued following the patient’s request at the end of two courses. A CT scan at 1 month after the discontinuation of chemotherapy did not reveal liver metastasis, and serum AFP level decreased to the normal range. He is alive at present with no re-recurrence and no elevation of serum AFP level at 7 years after the second surgery without any chemotherapy. Conclusion Even if recurrence of AFP-GC is diagnosed, radical resection and chemotherapy are effective, as noted in the present case.
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spelling doaj-art-dbc82c78e03a4a13bb0b536cfa733a5a2025-08-20T03:38:58ZengJapan Surgical SocietySurgical Case Reports2198-77932019-07-01511510.1186/s40792-019-0664-zA case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancerManabu Harada0Hironori Tsujimoto1Takashi Ichikura2Hiromi Nagata3Nozomi Ito4Shinsuke Nomura5Hiroyuki Horiguchi6Yoshihisa Yaguchi7Yoji Kishi8Hideki Ueno9Department of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeDepartment of Surgery, National Defense Medical CollegeAbstract Background Alpha-fetoprotein-producing gastric cancer (AFP-GC) is a relatively rare disease, with a dismal prognosis. Case presentation We report the case of a patient with long-term survival after surgery for the recurrence of AFP-GC. A 71-year-old man was diagnosed with gastric cancer and underwent distal gastrectomy with D2 lymphadenectomy (pT3N2M0). Pathological examination of the resected specimen revealed AFP-GC. Fifteen years after the gastrectomy, the patient experienced anorexia and was admitted with a mass located at the mesentery of the small intestine. Following a diagnosis of gastrointestinal stromal tumor of the mesentery, a tumor resection with partial small intestine was performed. The final histopathological diagnosis was AFP-GC’s recurrence in the small-bowel mesentery. Two months later, multiple liver metastases were identified, and serum AFP level was found to be extremely high (17,447 ng/mL). Chemotherapy with S-1+CDDP (SP) was initiated for liver metastasis. However, owing to anorexia and fatigue, SP therapy was discontinued following the patient’s request at the end of two courses. A CT scan at 1 month after the discontinuation of chemotherapy did not reveal liver metastasis, and serum AFP level decreased to the normal range. He is alive at present with no re-recurrence and no elevation of serum AFP level at 7 years after the second surgery without any chemotherapy. Conclusion Even if recurrence of AFP-GC is diagnosed, radical resection and chemotherapy are effective, as noted in the present case.http://link.springer.com/article/10.1186/s40792-019-0664-zAlpha-fetoproteinGastric cancerRecurrenceLong-term survival
spellingShingle Manabu Harada
Hironori Tsujimoto
Takashi Ichikura
Hiromi Nagata
Nozomi Ito
Shinsuke Nomura
Hiroyuki Horiguchi
Yoshihisa Yaguchi
Yoji Kishi
Hideki Ueno
A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer
Surgical Case Reports
Alpha-fetoprotein
Gastric cancer
Recurrence
Long-term survival
title A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer
title_full A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer
title_fullStr A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer
title_full_unstemmed A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer
title_short A case of a long-term survival achieved by surgical treatment and chemotherapy for late recurrence of AFP-producing gastric cancer
title_sort case of a long term survival achieved by surgical treatment and chemotherapy for late recurrence of afp producing gastric cancer
topic Alpha-fetoprotein
Gastric cancer
Recurrence
Long-term survival
url http://link.springer.com/article/10.1186/s40792-019-0664-z
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