[A case of alpha-fetoprotein producing embryonal carcinoma of the stomach]

A 67-year-old man with complaints of general malaise and epigastralgia was admitted to our hospital for further examination. Upper GI series and endoscopy showed advanced cancer, Borrmann type II; biopsy specimens revealed pathological pictures of malignancy. The serum alpha-fetoprotein values were remarkably high (473,000 ng/dl); the liver scintigram revealed a space-occupying lesion in the right lobe and the abdominal CT-scan showed ascites and lymphadenopathy of the abdominal para-aortic region. Therefore, double cancer of the stomach and the liver was suspected. The patient died in a state of hepatic coma with a rapid increase of jaundice, ascites and right pleural effusion at 3 weeks after admission despite the anti-cancer treatment. Autopsy revealed embryonal carcinoma with yolk sac tumor elements of stomach origin, extensive metastasis to the liver, lung, peritoneum, and portal vein. The peroxidase anti-peroxidase technique revealed that primary and secondary tumor cells produced alpha-fetoprotein.