Kurihara K, Konishi F, Kanazawa K, Fujii T, Saito K
Department of Surgery, Jichi Medical School, Tochigi, Japan.
Surg Today. 1997;27(5):453-6. doi: 10.1007/BF02385712.
We report herein the rare case of a 67-year-old man in whom alpha-feto-protein (AFP)-producing carcinoma originated in the transverse colon, describing the clinical course of the patient and the histological features of the tumor. At the age of 63, the patient had been diagnosed as having sigmoid colon carcinoma, and surgery was carried out. However, 4 years later, his fecal occult blood test was positive, and further investigation revealed a transverse colon carcinoma with liver metastasis. The serum AFP measured preoperatively was 10978 ng/ml. Resection of the transverse colon and a liver biopsy were performed, following which his serum AFP level decreased to 4804 ng/ml. Histology of the ulcerated lesion in the transverse colon showed a poorly differentiated adenocarcinoma with a medullary growth pattern. Using an immunohistochemical staining method, AFP-producing cells were detected in the transverse colon carcinoma and the liver metastasis. Based on our experience of this patient and a review of the literature on the few cases previously reported, we conclude that AFP-producing coloretal carcinoma has a tendency to produce blood-borne metastasis and to be associated with a poor prognosis.
我们在此报告一例罕见病例，一名67岁男性，其产生甲胎蛋白（AFP）的癌起源于横结肠，描述了该患者的临床病程及肿瘤的组织学特征。患者63岁时被诊断为乙状结肠癌并接受了手术。然而，4年后，他的粪便潜血试验呈阳性，进一步检查发现横结肠癌伴肝转移。术前测得的血清AFP为10978 ng/ml。进行了横结肠切除及肝脏活检，之后其血清AFP水平降至4804 ng/ml。横结肠溃疡病变的组织学检查显示为低分化腺癌，呈髓样生长模式。采用免疫组化染色方法，在横结肠癌及肝转移灶中检测到了产生AFP的细胞。基于我们对该患者的经验以及对先前报道的少数病例的文献回顾，我们得出结论，产生AFP的结直肠癌有血行转移倾向且预后较差。
