An Extremely Rare Presentation of an Alpha-Fetoprotein-Producing Esophageal Adenocarcinoma

Yaser Khalid; Neethi Dasu; Debashis Reja; Herman Suga; Michael Itidiare; Kirti Dasu; Richard Walters; Richard Gordon

doi:10.1159/000509503

An Extremely Rare Presentation of an Alpha-Fetoprotein-Producing Esophageal Adenocarcinoma

Case Rep Gastroenterol. 2020 Oct 20;14(3):497-503. doi: 10.1159/000509503. eCollection 2020 Sep-Dec.

Authors

Yaser Khalid¹, Neethi Dasu², Debashis Reja³, Herman Suga⁴, Michael Itidiare², Kirti Dasu⁵, Richard Walters², Richard Gordon⁶

Affiliations

¹ Division of Internal Medicine, Memorial Healthcare System, Hollywood, Florida, USA.
² Division of Gastroenterology, Rowan University School of Medicine at Jefferson Health System, Stratford, New Jersey, USA.
³ Division of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
⁴ Division of Internal Medicine, Rowan University School of Medicine at Jefferson Health System, Stratford, New Jersey, USA.
⁵ Division of Biology, Syracuse University, Syracuse, New York, USA.
⁶ Division of Hematology/Oncology, Comprehensive Cancer and Hematology Specialists, Voorhees, New Jersey, USA.

Abstract

Alpha-fetoprotein (AFP)-producing esophageal adenocarcinoma (EAC) is an extremely rare occurrence with very few cases reported in the literature. We report the case of a 76-year-old female who presented with progressive weakness, fatigue, and a decrease in appetite for weeks and who was found to have an AFP-producing EAC with an extraordinarily high AFP level of 46,135 ng/mL. CT angiography revealed abnormal thickening of the esophagus and multiple metastatic masses throughout the liver. Upper endoscopy revealed a large mass in the distal esophagus with extension into the stomach. Biopsy confirmed the EAC. Most cases are unsuccessfully treated with surgery and chemotherapy. Serial measurement of serum AFP may be useful for monitoring clinical status and treatment response.

Keywords: Alpha-fetoprotein; Esophageal cancer; Gastroesophageal reflux disease; Hepatocellular cancer.

Publication types

Case Reports