AFP産生十二指腸球部癌の1例

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  • A CASE OF ALPHA-FETOPROTEIN PRODUCING DUODENAL CANCER

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A 64-year-old woman was seen at the hospital because of epigastric discomfort and an abdominal mass, and was diagnosed as having a duodenal cancer on radiologic and endoscopic examinations. An alpha fetopro-tein (AFP) level of 480ng/ml was found on admission. An operation was performed under a diagnosis of AFP-producing duodenal cancer. At laparotomy, it was found that the main tumors developed on the bulbus of the duodenum with swelling of the periaortic lymph nodes. Pancreato-duodenectomy and dissection of D 4 were performed according to the general rules for gastric cancer study in Japan. The resected tumor was a Borrmann type 3 invading the head of the pancreas. The histological diagnosis was moderately differentiated tubular adenocarcinoma not composed of carcinoma cells with clear cytoplasm as in hepatoid carcinoma. Pro-duction of AFP in the tumor was demonstrated by an immunohistochemical technique (streptavidin biotin method).<br> AFP-producing tumors have been increasingly reported, but cases of primary duodenal cancer producing AFP are very rare. Here, we describe a case of AFP-producing duodenal cancer evidenced by immunohis-tochemical staining with some bibliographical comments.

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