A case of alpha-fetoprotein-producing barrett esophageal carcinoma with different histological patterns

We report the case of a patient with an alpha-fetoprotein (AFP)-producing esophageal carcinoma with different histological patterns. A 58-year-old man was admitted for bowel obstruction after undergoing appendectomy; he was found to have a protruding tumor in the lower esophagus. Tumor biopsy showed adenocarcinoma. Preoperative serum AFP concentration elevated to 3,788ng/ml. The patient underwent thoracoscopic esophagectomy with D2 regional lymphadenectomy and reconstruction using a gastric tube. Histological examination showed findings of combined carcinoma with enteroblastic differentiation, hepatoid adenocarcinoma, and tubular adenocarcinoma arising in Barrett esophagus. An immunohistochemical study yielded positive results for AFP. The patient received adjuvant chemotherapy with S-1. The serum AFP concentration decreased; the patient survived, and no recurrence has been observed for 22 months after the surgery. Few cases of AFP-producing esophageal carcinomas have been reported in the literature. In this study, we have described a very rare case of AFP-producing esophageal carcinoma.