Alpha-Fetoprotein-Producing Cancer That Derived in Barrett’s Esophageal Cancer after Chemotherapy

Yokomizo Kazuaki, Nemoto Hiroshi, Tate Genshu, Sakuraba Kazuma, Matsubara Taketo, Tanaka Junichi

doi:10.5833/jjgs.2016.0078

<p>A 64-year-old man was given a diagnosis of Barrett’s esophageal cancer. S1 and cisplatin combination chemotherapy was started. Type 2 cancer was obviously reduced by 2 courses of chemotherapy. However, a new type 1 lesion occurred in the lower end of the original ulcerated tumor after 5 courses of chemotherapy. Finally, the patient underwent subtotal esophagectomy and the esophagus was reconstructed using a gastric tube. Macroscopically the surgical specimen showed that at the lower esophagus, the congested type 1 cancer connected with the lower part of type 2 cancer that was covered with the epithelium. Microscopically, although both tumors consisted of adenocarcinoma, only type 1 cancer was stained for alpha-fetoprotein (AFP). In addition to type 1 cancer, 1 area in type 2 cancer was also stained for the new stem cell marker Sal-like protein (SALL) 4. He has survived relapse-free for 5 years after starting chemotherapy. This case is the 22nd report of AFP-producing esophageal cancer. As a result of investigating these cases, we conclude that the dedifferentiation of Barrett’s adenocarcinoma leads to AFP-producing cancer with high-grade malignancy. This is believed to be the first case of AFP-producing cancer that developed in Barrett’s esophageal cancer after chemotherapy. This case had interesting findings in relation to AFP and the new stem cell marker SALL4.</p>

Alpha-Fetoprotein-Producing Cancer That Derived in Barrett’s Esophageal Cancer after Chemotherapy

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