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| Format: | Recurso digital |
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Zenodo
2026
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| Online-Zugang: | https://doi.org/10.24966/GHR-2566/100059 |
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Inhaltsangabe:
- <p class="MsoNormal"><span>A 48-year-old woman was referred to gastroenterology for an isolated elevation of alpha-fetoprotein discovered during an annual health check-up. Liver function tests were normal. The ovaries and hormonal profile were also normal. Clinical manifestations appeared two years after the incidental finding of this laboratory abnormality. The patient reported nocturnal ulcer-type pain relieved by food intake and exacerbated by fasting. Upper gastrointestinal endoscopy revealed an ulcerated, exophytic tumor on the lesser curvature of the antrum. Biopsy results suggested a poorly differentiated adenocarcinoma, and surgery was indicated. After total gastrectomy, a second neuroendocrine tumor was incidentally identified in the antrum during histopathologic examination. There was no lymph node or locoregional infiltration, nor distant metastasis. The primary tumor was a poorly differentiated pT3 adenocarcinoma, and the neuroendocrine tumor was classified as mucosal pT1. Immunohistochemical staining for synaptophysin and chromogranin was positive. The mitotic index of the neuroendocrine tumor was 0/10 HPF, with a Ki-67 index below 1%. No alpha-fetoprotein staining was observed. The patient’s blood AFP level returned to normal one month after surgery, supporting the hypothesis of gastric origin of AFP secretion by the second neuroendocrine tumor. </span></p>