Alpha-fetoprotein-producing esophageal carcinoma: a case report

We report herein a rare case of esophageal carcinoma producing alpha-fetoprotein (AFP). A 69-year-old man presenting elevated AFP was admitted in order to investigate its origin, which several liver examinations done before admission had not revealed. At admission, his serum AFP was 76.9 ng/ml whereas other tumor markers were within normal range. As the patient complained of mild swallowing disturbance, gastrointestinal examinations were performed, and an esophageal carcinoma was found at the esophagogastric junction. The patient underwent subtotal esophagectomy and the esophagus was reconstructed by gastric tube. The postoperative course was uneventful and the serum AFP level normalized immediately after the operation. Histopathological examination demonstrated the tumor to be poorly-differentiated adenosquamous carcinoma, which contained scattered adenocarcinoma composed of clear cells positive to AFP by an immunohistochemical stain. The patient has been well for six months after the surgery without any sign of recurrence.