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Yu, Ahn, Chung, Kim, Yu, and Kim: A Case of Primary Lung Cancer Producing Alpha-fetoprotein
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(1): 72-76.

Published online: 30 January 2012

DOI: https://doi.org/10.4046/trd.2012.72.1.72

A Case of Primary Lung Cancer Producing Alpha-fetoprotein

Ji Hyun Yu, M.D., Joong Hyun Ahn, M.D., Han Hee Chung, M.D., Young Wook Kim, M.D., Jin Sok Yu, M.D., Ju Sang Kim, M.D.

Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.

Address for correspondence: Ju Sang Kim, M.D. Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, 665, Bupyeong 6-dong, Bupyeong-gu, Incheon 403-720, Korea. Phone: 82-32-280-5866, Fax: 82-32-280-5190, kimjusang@catholic.ac.kr

Received 30 August 2011       Revised 1 September 2011       Accepted 2 September 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

We observed a very rare case of primary lung cancer producing alpha-fetoprotein (AFP). A 70-year-old male with a history of smoking 50 packs per year was diagnosed with large cell carcinoma of the lung. The clinical stage was T2bN3M0 (IIIB), and serum AFP was 23,247 ng/mL. There was no evidence of metastasis to the liver, scrotum or other organs. While undergoing chemotherapy for 1 year, as the cancer progressed the AFP value steadily increased. The patient died of respiratory failure due to pneumonia 12 months after being diagnosed with lung cancer.

Keywords: alpha-Fetoproteins, Lung Neoplasms, Carcinoma, Large Cell

Figures and Tables

Figure 1
The initial chest X-ray revealed a 6×5.2 cm size mass in the left lower lobe.
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Figure 2
The initial chest CT image indicated a lobulated 6×5.2 cm size mass in the superior segment of the left lower lobe. CT: computed tomography.
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Figure 3
(A) Chest axial images showed a FDG-avid (SUV 12.2) round shape mass in the left lower lobe. (B) Multiple lymphadenopathies were in the right paratracheal, both hilar, subcarina, both peribronchial regions (SUV 6.6). PET-CT: positron emission tomography-computed tomography; FDG: fludeoxyglucose.
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Figure 4
Bronchoscopy revealed a polypoid mass-like lesion at the superior segment of the left lower lobe.
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Figure 5
Microscopic examination of the lung mass showed poorly differentiated large cell carcinoma with hepatoid pattern (H&E stain, ×100).
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Table 1
AFP and PIVKA-II levels in study subject
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*1st line chemotherapy regimen consisted of gemcitabine, cisplatin combination therapy. †2nd line chemotherapy regimen consisted of pemetrexed. ‡3rd line chemotherapy regimen consisted of gefitinib.

References

1. Gitlin D, Perricelli A, Gitlin GM. Synthesis of -fetoprotein by liver, yolk sac, and gastrointestinal tract of the human conceptus. Cancer Res. 1972. 32:979–982.
2. Ruoslahti E, Seppälä M. alpha-Fetoprotein in cancer and fetal development. Adv Cancer Res. 1979. 29:275–346.
3. Javadpour N. The National Cancer Institute experience with testicular cancer. J Urol. 1978. 120:651–659.
4. Adachi Y, Tsuchihashi J, Shiraishi N, Yasuda K, Etoh T, Kitano S. AFP-producing gastric carcinoma: multivariate analysis of prognostic factors in 270 patients. Oncology. 2003. 65:95–101.
5. Chang YC, Nagasue N, Kohno H, Taniura H, Uchida M, Yamanoi A, et al. Clinicopathologic features and long-term results of alpha-fetoprotein-producing gastric cancer. Am J Gastroenterol. 1990. 85:1480–1485.
6. O'Conor GT, Tatarinov YS, Abelev GI, Uriel J. A collaborative study for the evaluation of a serologic test for primary liver cancer. Cancer. 1970. 25:1091–1098.
7. Liebman HA, Furie BC, Tong MJ, Blanchard RA, Lo KJ, Lee SD, et al. Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N Engl J Med. 1984. 310:1427–1431.
8. No EJ, Hur JW, Lee SS, Lee YM, Lee HP, Kim JI, et al. A case of alpha-fetoprotien producing adenocarcinoma of the lung. Tuberc Respir Dis. 2006. 61:70–73.
9. Yasunami R, Hashimoto Z, Ogura T, Hirao F, Yamamura Y. Primary lung cancer producing alpha-fetoprotein: a case report. Cancer. 1981. 47:926–929.
10. Saka H, Sakai S, Kondo N, Ito M, Shimokata K. Successful resection of alpha-fetoprotein-producing lung cancer. Chest. 1988. 94:879–880.
11. Kitada M, Ozawa K, Sato K, Matsuda Y, Hayashi S, Tokusashi Y, et al. Alpha-fetoprotein-producing primary lung carcinoma: a case report. World J Surg Oncol. 2011. 9:47.
12. Hirota F, Hosaka K, Funahashi K, Oota M, Ikeda A, Oobayashi Y, et al. Effective treatment of AFP-producing lung cancer with UFT. Gan To Kagaku Ryoho. 1999. 26:381–384.
13. Takahashi Y, Inoue T, Fukusato T. Protein induced by vitamin K absence or antagonist II-producing gastric cancer. World J Gastrointest Pathophysiol. 2010. 1:129–136.
14. Arnould L, Drouot F, Fargeot P, Bernard A, Foucher P, Collin F, et al. Hepatoid adenocarcinoma of the lung: report of a case of an unusual alpha-fetoprotein-producing lung tumor. Am J Surg Pathol. 1997. 21:1113–1118.
15. Ishikura H, Kanda M, Ito M, Nosaka K, Mizuno K. Hepatoid adenocarcinoma: a distinctive histological subtype of alpha-fetoprotein-producing lung carcinoma. Virchows Arch A Pathol Anat Histopathol. 1990. 417:73–80.
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