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Alpha-fetoprotein (AFP) is a common tumor marker for hepatocellular carcinoma (HCC). We report a unique case of an AFP-producing gastric cancer in an elderly man with known chronic hepatitis B (HBV) and a markedly elevated AFP. Thorough diagnostic imaging failed to reveal a HCC, but a gastric adenocarcinoma was found on endoscopy. After successful resection, the serum AFP normalized. On histopathologic examination, the cancer demonstrated focal positive staining for AFP, in keeping with a hepatoid gastric adenocarcinoma. Endoscopy should be considered in clinical situations where increased serum AFP is detected but no HCC is found.

Alpha Fetoprotein-Secreting Gastric Cancer in the Setting of Chronic Hepatitis B: The Role of Endoscopy