A 84 year-old myocardial ischemia man with stenting cononary artery in annual check-up.
Since September 2023, AFP value was 6,015 ng/mL, and April 2024, ultrasound and MSCT detected an exophytic cardia gastric wall tumor # 69x90x30mm and metastatic lymph nodes.
But gastric endoscopy was negative.
While AFP value elevated highly 3,667 ng/mL ultrasound and MSCT detected no liver tumor.
Later in May 2024, the cardia gastric wal tumor # 82x83mm, and lymph nodes were getting bigger on ultrasound and MSCT .
A higher AFP value =5,685 ng/mL noted again. And at that time, it appeared some liver nodules in the right and left lobe =73-61-46-20-14mm on ultrasound. The echogenic structure of these nodules were complex, one hyperechoic, another mixed echoic that might come from the gastric tumor instead a multiple HCC.
No surgery was performed for the elderly patient and he died some days in this week.
But in the literature there were only 6 cases of the gastric tumor with high value of AFP . These cases belong to the primary gastric yolk sac tumor with immunohistochemistry stain results.
The primary gastric yolk sac tumor with high value of AFP is still a very rare malignant entity.