[alpha-fetoprotein producing rectal cancer].

A 73-year-old man with a diagnosis of rectal cancer concomitant with multiple liver metastases underwent resection of the primary lesion. The postoperative immunohistochemical study revealed AFP production in the cancer tissue. The initial serum level of AFP after operation was 721 ng/mL. Although the mFOLFOX6 regimen had been started as the first postoperative chemotherapy, the AFP is serum level aggressively elevated to 9, 521 ng/mL and the size of the liver metastases markedly increased. As a second choice of treatment, transarterial chemo-embolization(TACE)using epirubicin hydrochloride and Lipiodol was performed because it was reported to have a high efficacy. After two sessions of the TACE, the serum level of the AFP decreased to 130 ng/mL and the size of the liver metastases reduced by approximately 30%in diameter. The third session of TACE, however, was unable to prevent re-progression of the liver lesion and the development of lung metastases. The patient died of hepatic failure 9 months after operation. It is known that AFP-producing colorectal cancers frequently develop life-limiting liver metastases. As shown in the present case, transcatheter drug delivery exclusively to the lesion in the liver might be the first choice for improving patient survival.