Salvage surgery after chemotherapy with S-1 plus cisplatin for α-fetoprotein-producing gastric cancer with a portal vein tumor thrombus: a case report

BMC Surgery

Case Report

Mayumi Inaba¹  Takeshi Hori²  Bunzo Nakata²  Masashige Tendo²  Kenji Kuroda²  Shigetomi Nakao²  Tetsuro Ishikawa²  Kosei Hirakawa³ 

[1] Department of Pathology, Osaka City University Graduate School of Medicine, 1-4-3 AsahimachiAbeno-ku, 545-8585, Osaka, Japan;Department of Surgery, Kashiwara Municipal Hospital, 1-7-9 Hozenji, 582-0005, Kashiwara City, Osaka, Japan;Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 AsahimachiAbeno-ku, 545-8585, Osaka, Japan;

关键词: Neoadjuvant chemotherapy;    α-fetoprotein-producing gastric cancer;    Portal vein tumor thrombus;   

DOI  :  10.1186/1471-2482-15-5

 received in 2014-09-12, accepted in 2015-01-08,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPatient with α-Fetoprotein (AFP)-producing gastric cancer usually has a short survival time due to frequent hepatic and lymph node metastases. Gastric cancer with portal vein tumor thrombus (PVTT) is rare and has an extremely poor prognosis.Case presentationA 63-year-old man was found to have a huge Type 3 gastric cancer with a PVTT and a highly elevated serum AFP level. Chemotherapy with S-1 plus cisplatin was given to this patient with unresectable gastric cancer for 4 months. The serum AFP level decreased from 6,160 ng/mL to 60.7 ng/mL with chemotherapy. Since the PVTT disappeared after the chemotherapy, the patient underwent total gastrectomy. Histological findings of the primary tumor after chemotherapy showed poorly differentiated adenocarcinoma without hepatoid cells and viable tumor cells remaining in less than 1/3 of the neoplastic area of mucosa and one lymph node. The cancerous cells were immunohistochemically stained by anti-AFP antibody. The patient has survived for 48 month without recurrence.ConclusionsAFP-producing gastric cancer with a PVTT has an extremely poor prognosis, but long-term survival was achieved for this dismal condition by salvage surgery after chemotherapy.

【 授权许可】

Unknown   
© Nakao et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.