Des-gamma-carboxy prothrombin (PIVKA-II) -producing mediastinal embryonal carcinoma with features of hepatoid differentiation
Hasegawa, Y.; Tomita, K.; Hashimoto, K.; Shigeoka, Y.; Watanabe, M.; Yamasaki, A.; Shimizu, E.
Anticancer Research 25(6c): 4569-4571
2005
ISSN/ISBN: 0250-7005 PMID: 16334143 Document Number: 586978
The case of a 48-year-old man with primary nonseminomatous embryonal carcinoma at the posterior mediastinium is described. The patient displayed extremely high plasma levels of Des-gamma-carboxy prothrombin (PIVYA-11) (4040 mAU/ml). Ultrasonography and dynamic computed tomography ruled out hepatocellular carcinoma (HCC) or liver metastasis. After preoperative systemic chemotherapy, total tumor resection was performed. Postoperatively, the plasma levels of PTVKA-II returned to within the normal range (24 mAU/ml). An immunohistochemical study using anti-PIVYA-II monoclonal antibody revealed the cytoplasmic expression of PIVKA-II in the carcinoma cells. These results indicate that tumor cells, which are manifested as hepatoid differentiation, may produce PIVKA-II. This case seems to be the first case reported in which PIVKA-II was produced by nonseminomatous mediastinal embryonal carcinoma without HCC or liver metastasis.