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Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report

BACKGROUND: Alpha-fetoprotein (AFP) is produced by some tumors, such as hepatocellular carcinoma and yolk sac tumors, leading to an increase in serum AFP level. However, AFP in colorectal cancer is extremely rare. Treatment for AFP-producing cancer is often performed according to conventional method...

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Autores principales: Nakamura, Yuki, Matsuda, Kenji, Yokoyama, Shozo, Tamura, Koichi, Mitani, Yasuyuki, Iwamoto, Hiromitsu, Mizumoto, Yuki, Murakami, Daisuke, Fujimoto, Masakazu, Yamaue, Hiroki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127073/
https://www.ncbi.nlm.nih.gov/pubmed/30191347
http://dx.doi.org/10.1186/s40792-018-0520-6
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author Nakamura, Yuki
Matsuda, Kenji
Yokoyama, Shozo
Tamura, Koichi
Mitani, Yasuyuki
Iwamoto, Hiromitsu
Mizumoto, Yuki
Murakami, Daisuke
Fujimoto, Masakazu
Yamaue, Hiroki
author_facet Nakamura, Yuki
Matsuda, Kenji
Yokoyama, Shozo
Tamura, Koichi
Mitani, Yasuyuki
Iwamoto, Hiromitsu
Mizumoto, Yuki
Murakami, Daisuke
Fujimoto, Masakazu
Yamaue, Hiroki
author_sort Nakamura, Yuki
collection PubMed
description BACKGROUND: Alpha-fetoprotein (AFP) is produced by some tumors, such as hepatocellular carcinoma and yolk sac tumors, leading to an increase in serum AFP level. However, AFP in colorectal cancer is extremely rare. Treatment for AFP-producing cancer is often performed according to conventional methods, but oncological outcomes of both surgery and chemotherapy are poor. We report a case of a patient with AFP-producing rectal cancer which successfully responded to preoperative chemoradiotherapy. CASE PRESENTATION: Rectal tumor was diagnosed in a 68-year-old man referred to our hospital. Colonoscopy showed a type 2 tumor in the lower rectum, and biopsy revealed an adenocarcinoma with enteroblastic differentiation. Serum tumor marker levels were 8.8 ng/ml in carcinoembryonic antigen (CEA) and 28.3 ng/ml in AFP. Clinical diagnosis was stage IIIB (T3N1M0), and preoperative chemoradiotherapy was performed to prevent local recurrence. Effective tumor reduction was observed, and serum tumor marker levels decreased to normal range. Low anterior resection with temporary diverting ileostomy was performed, and histology revealed residual adenocarcinoma. Pathological diagnosis was stage I (T2N0M0). The tumor was found to be an AFP-producing adenocarcinoma on further immunohistopathological examination. The postoperative course was uneventful, and the patient received adjuvant chemotherapy for 3 months. CONCLUSIONS: The outcomes of preoperative chemoradiotherapy against AFP-producing rectal cancer are reported here for the first time. Based on our experience with this patient, it appears preoperative chemoradiotherapy for patients with AFP-producing advanced rectal cancer is feasible.
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spelling pubmed-61270732018-09-11 Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report Nakamura, Yuki Matsuda, Kenji Yokoyama, Shozo Tamura, Koichi Mitani, Yasuyuki Iwamoto, Hiromitsu Mizumoto, Yuki Murakami, Daisuke Fujimoto, Masakazu Yamaue, Hiroki Surg Case Rep Case Report BACKGROUND: Alpha-fetoprotein (AFP) is produced by some tumors, such as hepatocellular carcinoma and yolk sac tumors, leading to an increase in serum AFP level. However, AFP in colorectal cancer is extremely rare. Treatment for AFP-producing cancer is often performed according to conventional methods, but oncological outcomes of both surgery and chemotherapy are poor. We report a case of a patient with AFP-producing rectal cancer which successfully responded to preoperative chemoradiotherapy. CASE PRESENTATION: Rectal tumor was diagnosed in a 68-year-old man referred to our hospital. Colonoscopy showed a type 2 tumor in the lower rectum, and biopsy revealed an adenocarcinoma with enteroblastic differentiation. Serum tumor marker levels were 8.8 ng/ml in carcinoembryonic antigen (CEA) and 28.3 ng/ml in AFP. Clinical diagnosis was stage IIIB (T3N1M0), and preoperative chemoradiotherapy was performed to prevent local recurrence. Effective tumor reduction was observed, and serum tumor marker levels decreased to normal range. Low anterior resection with temporary diverting ileostomy was performed, and histology revealed residual adenocarcinoma. Pathological diagnosis was stage I (T2N0M0). The tumor was found to be an AFP-producing adenocarcinoma on further immunohistopathological examination. The postoperative course was uneventful, and the patient received adjuvant chemotherapy for 3 months. CONCLUSIONS: The outcomes of preoperative chemoradiotherapy against AFP-producing rectal cancer are reported here for the first time. Based on our experience with this patient, it appears preoperative chemoradiotherapy for patients with AFP-producing advanced rectal cancer is feasible. Springer Berlin Heidelberg 2018-09-06 /pmc/articles/PMC6127073/ /pubmed/30191347 http://dx.doi.org/10.1186/s40792-018-0520-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Nakamura, Yuki
Matsuda, Kenji
Yokoyama, Shozo
Tamura, Koichi
Mitani, Yasuyuki
Iwamoto, Hiromitsu
Mizumoto, Yuki
Murakami, Daisuke
Fujimoto, Masakazu
Yamaue, Hiroki
Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
title Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
title_full Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
title_fullStr Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
title_full_unstemmed Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
title_short Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
title_sort alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127073/
https://www.ncbi.nlm.nih.gov/pubmed/30191347
http://dx.doi.org/10.1186/s40792-018-0520-6
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