Volume 77 - 2014 - Fasc.1 - Case reports
A challenging alfa-fetoprotein in a cirrhotic patient
A 57-year-old Italian man was admitted to our Hospital for in- vestigation of a progressively raising alfa-fetoprotein (AFP) on the background of chronic hepatitis B infection. At abdominal imag- ing, liver morphology was suspected for advanced fibrosis but with- out any focal lesion. Clinical and ultrasonographic examinations were negative for testicular masses. When the patient was screened for gastroesophageal varices, upper intestinal endoscopy did not show signs of portal hypertension, while it revealed a gastric lesion which was histologically characterized as hepatoid adenocarcino- ma of the stomach (HAS), with strong immunohistochemical posi- tivity for AFP. The patient underwent subtotal gastrectomy and AFP fell within the normal range. This is a very rare case in which AFP-producing gastric cancer (AFPPGC), in the form of HAS, presented in a patient with chronic liver disease. Physicians should be particularly aware of AFPPGC when following patients with liver disorders due to the common use of AFP in this setting. (Acta gastroenterol. belg., 2014, 77, 66-67).
Ectopic liver tissue in two distinct anatomical regions : a case report
Extrahepatic liver tissue (ELT) is a rare clinical finding. Few cases are described. The reported location is almost exclusively confined to the subdiaphragmatic region with the gallbladder being the most frequent localisation. This paper describes a unique case with not only two localisations of ectopic liver tissue, but also in anatomical regions where ELT has never been described before. (Acta gastroenterol. belg., 2014, 77, 68-70).
Venous thrombosis in a child with ulcerative colitis in remission : a case report
Over the past 70 years, an association between venous thrombo- embolism and inflammatory bowel disease has been described. We report on a thirteen year old boy with ulcerative colitis and venous thrombosis. Literature on incidence of venous thromboembolism in inflammatory bowel disease (IBD) is reviewed as well as the possible pathogenetic mechanisms of this 'hypercoagulable state' : role of acquired risk factors, inflammation, coagulation abnormali- ties and platelets. Finally, treatment of IBD and thrombosis is discussed. (Acta gastroenterol. belg., 2014, 77, 71-74).