α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component

Abstract

Abstract. endometrial carcinomas producing α-fetoprotein (AFP) are extremely rare. We report a case of AFP-producing, grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. A 59-year-old multiparous woman presented with abdominal swelling. the serum level of AFP was 1292.8 ng/ml. Magnetic resonance images of the pelvis showed a markedly enlarged uterus, with a tumor growing exophytically within the endometrial cavity. total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. the histopathological examination demonstrated a stage IIA, grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. the endometrioid adenocarcinoma cells were partly positive for AFP immunoreactivity. the patient received adjuvant chemotherapy and was diseasefree 60 months after the operation. This case confirms the existence of AFP-producing endometrioid adenocarcinomas without hepatoid features.

-fetoprotein produced by endometrioid adenocarcinoma of uterus

“…Hepatoid carcinoma should essentially be diagnosed on the basis of histological features of the tumour. It is characterised by the medullary or papillotubular arrangement of tumour cells with eosiophilic and granular cytoplasm, thus resembling hepatocellular carcinoma 4. But in some cases such as ours and the case reported by Kodama et al 4 there was not any evidence of hepatoid differentiation despite AFP production.…”

“…It is characterised by the medullary or papillotubular arrangement of tumour cells with eosiophilic and granular cytoplasm, thus resembling hepatocellular carcinoma 4. But in some cases such as ours and the case reported by Kodama et al 4 there was not any evidence of hepatoid differentiation despite AFP production. AFP producing adenocarcinoma can be carcinomatous part of a malignant mixed mullerian tumour 3 5 7.…”

“…In most studies, these tumours were seen in women in their 60s but an 83-year-old woman was reported by Ishibashi et al 8. Most of them were high grade1–3 5 although a case reported by Kodama et al 4 was not high grade. Lung metastases are common, and the disease has poor prognosis,1–3 5 and tumours recurred or lead to death within 12 months of diagnosis in most of cases,8 however few patients with long-time survival have been reported 4 8.…”

“…AFP is a significant serum protein with a half life of 5.8 days being synthesised during fetal life, and the expression of the AFP gene is dramatically reduced after birth 4. AFP is synthesised only to a very limited extent in normal adult tissues.…”

“…AFP is synthesised only to a very limited extent in normal adult tissues. Besides hepatocellular carcinoma and yolk sac tumour adenocarcinoma from different origin can produce AFP 1–4. Hepatoid carcinomas are a rare group of extrahepatic tumours and have been found in the stomach, pancreas, kidney, bladder and ovary.…”