Extremely high expression of serum alpha-fetoprotein level of gastric adenocarcinoma: a rare case with an unexpected well-prognosis

INTRODUCTION: Alpha-fetoprotein (AFP)-producing gastric cancer is a relatively rare form of stomach malignancy. Patients with higher serum AFP level (>300 ng/mL) will have a poorer prognosis. CASE DESCRIPTION: In this study, we present a case of 77-year-old woman with an extremely high expression of serum AFP level (>10,000 ng/mL) of gastric cancer. Histological examination revealed gastric adenocarcinoma (Bormann III gastric tumor) invading into the serosal layer and vessel. After receiving a successful total gastrectomy with D2 dissection, this patient underwent chemotherapy with SOX [oxaliplatin (130 mg/m(2)/day) iv. at day 1 + S-1 (80 mg/m(2)/day) from day 1–day 14]. The patient remains alive without disease for 29 months after surgery. Serum AFP level decreased to normal range. DISCUSSION AND EVALUATION: We have evaluated the level of AFP, and discussed the reason for the good prognosis for this patient. CONCLUSIONS: The good prognosis may be related with her early stage (N0 and without liver metastasis) and radical surgery.