AFP-producing adenocarcinoma of the esophagogastric junction: report of a case with atypical immunohistochemical findings responding to palliative chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT regime)

U. Häussler; M. Bitzer; H. Bösmüller; S. Clasen; M. Götz; N. P. Malek; R. R. Plentz

doi:10.1055/s-0042-114575

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2016; 54(10): 1147-1150
DOI: 10.1055/s-0042-114575

Kasuistik

AFP-producing adenocarcinoma of the esophagogastric junction: report of a case with atypical immunohistochemical findings responding to palliative chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT regime)

AFP-produzierendes Adenokarzinom des ösophago-gastralen Übergangs: Ein Fallbericht mit ungewöhnlichen Befunden in der immunhistochemischen Analyse und einem Ansprechen auf eine Chemotherapie mit 5-Fluorouracil, Leucovorin, Oxaliplatin und Docetaxel (FLOT-Regime)

Authors

U. Häussler

¹Department of Internal Medicine I, Medical University Hospital, Tübingen, Germany
M. Bitzer

¹Department of Internal Medicine I, Medical University Hospital, Tübingen, Germany
H. Bösmüller

²Institute of Pathology, Medical University Hospital, Tübingen, Germany
S. Clasen

³Department for Diagnostic and Interventional Radiology, Medical University Hospital, Tübingen, Germany
M. Götz

¹Department of Internal Medicine I, Medical University Hospital, Tübingen, Germany
N. P. Malek

¹Department of Internal Medicine I, Medical University Hospital, Tübingen, Germany
R. R. Plentz

¹Department of Internal Medicine I, Medical University Hospital, Tübingen, Germany

Abstract

AFP-producing adenocarcinoma of the esophagus and esophagogastric junction are rare tumor diseases. These tumors show an aggressive behavior characterized by early occurrence of liver metastases and mimic hepatocellular carcinoma (HCC). A general recommendation for palliative therapy is not established for these special tumors.

Here we report about a 61-year-old man with multiple liver metastases and high serum alpha-fetoprotein (AFP) level. First, HCC was suspected, but further evaluation showed an AFP-producing adenocarcinoma of the esophagogastric junction with unusual findings on further immunohistochemical analysis. Palliative chemotherapy with FLOT (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel) regime showed a 9 month duration of partial response.

Zusammenfassung

AFP-produzierende Adenokarzinome des Ösophagus und ösophago-gastralen Übergangs sind seltene Tumorerkrankungen. Diese Tumore zeigen ein aggressives Wachstumsverhalten und sind gekennzeichnet durch eine frühe hepatische Metastasierung. Histopathologisch gibt es Ähnlichkeiten zum hepatozellulären Karzinom (HCC). Die palliative Therapie dieser Tumoren ist bislang nicht standardisiert.

Wir berichten über einen 61-jährigen Patienten mit multiplen Lebermetastasen und einer hohen Serum-Alpha-Fetoprotein- (AFP) Konzentration. Zunächst wurde ein HCC vermutet, jedoch erbrachten die weiteren Untersuchungen den Nachweis eines AFP-produzierenden Adenokarzinoms des ösophago-gastralen Übergangs mit ungewöhnlichen Befunden in der immunhistochemischen Analyse. Unter einer palliativen Chemotherapie nach dem FLOT-Regime (5-Fluorouracil, Leucovorin, Oxaliplatin and Docetaxel) zeigte sich eine partielle Tumorremission für eine Zeitdauer von neun Monaten.

Schlüsselwörter

Ösophaguskarzinom - Magenkarzinom - Barrett-Oesophagus

Key words

esophagus carcinoma - gastric cancer - barrett esophagus

Full Text

References

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