@article{oai:hama-med.repo.nii.ac.jp:00000042,
 author = {東, 正樹 and 鈴木, 昌八 and 坂口, 孝宣 and 太田, 茂安 and 稲葉, 圭介 and 馬場, 聡 and 今野, 弘之 and 中村, 達},
 issue = {8},
 journal = {日本消化器外科学会雑誌, The Japanese Journal of Gastroenterological Surgery},
 month = {Aug},
 note = {症例は67歳の男性で, C型肝炎のため近医で経過観察されていた．1999年8月, 血清AFP値の上昇と腹部超音波検査で肝腫瘤を認めたため, 当科紹介受診した．肝臓および上部消化管の精査で肝右葉に門脈前区域枝の腫瘍栓を伴う7.5cm大の腫瘍と残胃にtype 2病変を認めた．肝細胞癌を合併した残胃癌と診断し, 経皮経肝門脈枝塞栓術後に肝拡大右葉切除術, 残胃部分切除術を施行した．病理組織学的検査では胃, 肝腫瘍ともにAFP免疫染色陽性の低分化型腺癌であり, AFP産生残胃癌および肝転移と診断された．術後補助化学療法を施行し, 5年2か月の現在無再発生存中である．AFP産生胃癌は肝, リンパ節転移を来すことが多く, 通常の胃癌より生物学的悪性度が高く予後不良とされている．本症例では原発巣と門脈腫瘍栓を伴う肝転移巣が1期的に根治切除できたことが良好な予後が得られている一要因と考えられた．, We report a 67-year-old man with alpha-fetoprotein (AFP)-producing gastric cancer and synchronous liver metastasis with a portal tumor thrombus. After being followed up elsewhere for hepatitis C virus infection, he was admitted in August 1999 for a liver tumor found due to high serum AFP. Abdominal CT showed a 7.5cm-diameter tumor developing into a portal branch in the right hepatic lobe. Gastrointestinal fiberscopy showed a type 2 tumor in the remnant stomach, histologically diagnosed as poorly differentiated adenocarcinoma. We diagnosed lesions as hepatocellular carcinoma and gastric cancer in the remnant stomach. Three weeks after percutaneous transhepatic portal embolization, we conducted extended right hepatic lobectomy and partial gastric resection. Since both hepatic and gastric tumors were positive for AFP immunohistochemical staining, we diagnosed him histologically as having AFP-producing gastric cancer with liver metastasis. He underwent adjuvant chemotherapy with 5-FU and CDDP and is doing well without recurrence more than 5 years after surgery.},
 pages = {1301--1305},
 title = {5年無再発生存中の門脈腫瘍栓を伴うAFP産生残胃癌肝転移の1例},
 volume = {38},
 year = {2005}
}