Alpha-fetoprotein-producing early rectal carcinoma: a rare case report and review

Abstract

BackgroundAlpha-fetoprotein (AFP)-producing rectal cancer is very rare, and this type of cancer frequently metastasizes to the liver with a poor prognosis. To date, only 11 cases of AFP-producing colorectal cancer have been reported.Case presentationA 41-year-old woman was first presented to the hospital for anal bleeding. An elevated tumor with a central shallow depression in the lower rectum was detected by colonoscopy. Transanal excision was performed, and the histology revealed adenocarcinoma. Further immunohistopathological examination revealed that the tumor was an AFP-producing adenocarcinoma of the rectum. Although local resection was performed 2 months before the diagnosis of AFP tumor, the serum AFP level was normal. The depth of the submucosal invasion was 5,000 μm, and there was venous invasion. Also, no lymphatic invasion was detected. Therefore, additional surgical resection with lymph node dissection was conducted, and the patient underwent laparoscopic intersphincteric resection. No residual cancer was identified in the surgical specimens, and there was no evidence of lymph node metastasis. The patient was discharged 18 days postoperatively, and 12 months after the operation, there are no signs of recurrence.ConclusionTo the best of our knowledge, this is the first case of an AFP-producing rectal cancer that was diagnosed at an early stage.

The Carcinogenic Agent Diethylnitrosamine Induces Early Oxidative Stress, Inflammation and Proliferation in Rat Liver, Stomach and Colon: Protective Effect of Ginger Extract

“…The majority of AFP-producing cancers originate from the stomach, bile duct, and pancreas. Clinically, eleven cases of colorectal cancer with only one case with early rectal cancer have been diagnosed as an AFP-producing tumor by immunohistochemistry (Anzai et al, 2015). Hepatic, gastric and colonic contents of AFP were markedly decreased by ginger extract pretreatment by approximately 50% compared to DENA group in a dose dependent manner.…”

Clinicopathologic Features and Prognostic Factors in Alpha-Fetoprotein-Producing Colorectal Cancer: Analysis of 78 Cases

“…The reported cases of AFPP-CRC have generally occurred in middleaged to older men with the rectum most commonly affected. Most reported cases of AFPP-CRC had very poor prognosis due to liver or lymph node metastases at the time of diagnosis, and the serum AFP level is usually as high as several-thousand nanograms per milliliter [14]. Therefore, AFP could be considered as a potential marker for tumor activity and a predictor for survival.…”

“…Apart from these classic tumors, AFP has been detected in several other organs, and recently reported cases of AFP-producing tumors of the stomach [8], pancreas [9], bile duct [10], lung [11], kidney [12], and ovary [13] have increased. Alpha-fetoprotein-producing colorectal cancer (AFPP-CRC) is extremely rarely seen and only 16 cases could be referred to in the English literature to date [14][15][16]. In 1985, Nakajima [17] first reported a patient of AFP-producing rectal cancer bearing liver and lung metastasis.…”

“…In 1985, Nakajima [17] first reported a patient of AFP-producing rectal cancer bearing liver and lung metastasis. Since then, scattered cases of AFPP-CRC have been reported, and these case reports showed that it was always associated with later stage, lymph node metastasis, liver metastasis, and dismal prognosis [14]. At present, to our best knowledge, there is no consistent definition for AFPP-CRC.…”

Alpha-fetoprotein: A fabulous biomarker in hepatocellular, gastric and rectal cancer diagnosis

“…It is also involved in the delivery of variety of other ligands including organic drugs. This feature of AFP makes it a potent biomarker in studying the effect of various drugs on tumor growth [4].…”