생식 세포종양으로 오인된 위의 간세포양 샘암종 1예
A case of gastric hepatoid adenocarcinoma misdiagnosed as an extragonadal germ cell tumor
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참고문헌
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초록
저자들은 위암 2기(T2N1M0)로 근치적 수술을 시행받은 후 추적 관찰 중 5개월 만에 높은 AFP수치(227,325 IU/mL)와 다수의 간 내 다발성 종괴 및 복강내 종양소견이 관찰되어 시행한 간 조직 검사와 면역조직화학염색을 통해 간세포양 샘암종으로 진단된 증례를 경험하였기에 보고하는 바이다.
Abstract
Hepatoid adenocarcinoma is a rare variant of adenocarcinoma that can occur in the stomach. This neoplasm has a poor prognosis and it frequently presents at an advanced stage of disease; it is clinically characterized by increased serum levels of alpha-fetoprotein (AFP) in most cases. We experienced a case of hepatoid adenocarcinoma of the stomach with multiple liver metastases that mimicked germ cell tumor in a 43-year-old man. He had incidentally detected gastric adenocarcinoma via gastrofibroscopy and he underwent subtotal gastrectomy. The postoperative pathologic stage was II (T2N1M0). He complained of epigastric pain. The serum AFP was markedly increased (227,325 IU/mL) and abdominal CT revealed multiple liver masses. We considered these as extragonadal germ cell tumors that occurred in the liver because of the markedly elevated AFP, the short duration of follow-up and early stage of stomach cancer at the that time. To confirm the diagnosis, biopsy of liver mass was done and he was diagnosed with hepatoid adenocarcinoma.(Korean J Med 73:107-111, 2007)
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