A Case of Alpha-Fetoprotein Producing Gastric Carcinoma Complicated with Portal Venous Tumor Thrombosis

A 71-year-old male was admitted to Nagashio Hospital for examinations of anemia and ascites. Laboratory findings showed liver dysfunction and a high level of serum alpha-fetoprotein (AFP). An upper gastrointestinal series and endoscopy revealed Borrmann III type carcinoma in the stomach. Biopsy revealed well to moderately differentiated adenocarcinoma. Ultrasonography, computed tomography and magnetic resonance imaging showed hypovascular tumors in the bilateral lobes of the liver, and massive venous thrombosis in the portal trunk and intrahepatic portal vein. Conservative therapy was given, and the patient died 12 weeks after admission. A necropsy specimen of liver tumor revealed well to moderately differentiated adenocarcinoma, and immunohistochemical staining for AFP was positive. We concluded that portal venous thrombus formation had occurred due to liver metastasis from AFP-producing gastric carcinoma