Alpha-fetoprotein and human chorionic gonadotropin-producing lung cancer

Abstract

A 73-year-old man had primary lung cancer that produced both alphafetoprotein (AFP) and human chorionic gonadotropin (HCG). The preoperative serum AFP level of 1039 ng/ml decreased to the normal range 8 weeks after surgery. The preoperative serum HCG level of 11 mIU/ml, which temporarily decreased to the normal range after operation, soon increased thereafter. The serum HCG level decreased, however, to the normal range after postoperative mediastinal radiation therapy. During relapse, only the serum HCG level increased gradually to 26,000 mIU/ml 7 weeks before his death. The lung cancer was classified histologically as poorly differentiated adenocarcinoma. Immunohistochemically, AFP was detected in the mononuclear tumor cells of the primary tumor in the lung, and HCG was found in the giant cells of the subcarinal metastatic lymph node. The concanavalin A non-reactive fraction rate for AFP was 81.3%, and appeared to differ from those of hepatocellular carcinoma and yolk sac tumor.

Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] All 16 patients were men with large lung tumors. The majority of patients presented with advanced stage disease.…”

“…[3][4][5][6][7][8][9]11,12,16,17 AFP immunoassays, ordered by clinicians in three of five current cases, showed marked elevation of serum AFP in one patient (4410 ng/ml). A normal AFP level was concordant with the negative immunohistochemical stain for AFP in one case.…”

“…The intensity score was assigned according to staining intensity: 0, none; 1, weak; 2, intermediate; and 3, strong. Intensity score and proportion score were added together for a combined immunohistochemical score: negative (0), weak (2-4) and strong (5)(6)(7)(8).…”

“…There are only 16 case reports of hepatoid adenocarcinoma of lung in the literature (Table 1). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Anatomic pathologists should be cognizant of this rare tumor to avoid confusion with metastatic hepatocellular carcinoma. We report four male patients and one female patient with hepatoid adenocarcinoma of lung, modify the diagnostic criteria of Ishikura et al 2 and discuss an immunohistochemical panel to distinguish hepatoid adenocarcinoma of lung from hepatocellular carcinoma metastatic to lung.…”

Primary Hepatoid Adenocarcinoma of the Lung

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Among them, 21 were males and nine were heavy smokers. Majority Alpha-fetoprotein is produced by yolk sac and fetal liver.…”