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Elevated paraneoplastic hypercholesterolemia in a case of hepatoid adenocarcinoma of the stomach with liver metastasis

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Abstract

A 67-year-old man was admitted to our hospital because of a large liver tumor revealed by ultrasonography. Laboratory data showed increased serum levels of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), which are tumor markers for hepatocellular carcinoma. In addition, the serum cholesterol level was extremely high. Endoscopic examination revealed advanced gastric cancer. Histological findings of the stomach and liver tumor showed they were both hepatoid adenocarcinomas and were both positive for antibodies against AFP as well as DCP, suggesting that the tumors were gastric cancer with liver metastasis. Moreover, 3-hydroxyl-3-methylglutaryl coenzyme A (HMG-CoA) reductase, a key enzyme for regulation of cholesterol synthesis, was upregulated in the tumor tissues. Accordingly, we diagnosed this patient with AFP- and DCP-producing gastric cancer accompanied by paraneoplastic hypercholesterolemia. Paraneoplastic hypercholesterolemia is sometimes seen in hepatocellular carcinoma, but never in gastric cancer. This case is interesting because of the feature of hepatoid adenocarcinoma.

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Disclosures

Conflict of Interest: The authors declare that they have no conflict of interest.

Human/Animal Rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent: Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Gastroenterology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    Tetsuro Sohda, Koichi Eguchi, Kunihiko Aoyagi & Shotaro Sakisaka

  2. Sakura Hospital, 4-16-15 Katae, Jonan-ku, Fukuoka, 814-0142, Japan

    Hiroyuki Kusuhara, Yoshiki Egashira & Keisuke Egashira

Authors
  1. Tetsuro Sohda
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  2. Hiroyuki Kusuhara
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  3. Yoshiki Egashira
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  4. Keisuke Egashira
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  5. Koichi Eguchi
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  6. Kunihiko Aoyagi
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  7. Shotaro Sakisaka
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Correspondence to Tetsuro Sohda.

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Sohda, T., Kusuhara, H., Egashira, Y. et al. Elevated paraneoplastic hypercholesterolemia in a case of hepatoid adenocarcinoma of the stomach with liver metastasis . Clin J Gastroenterol 6, 424–428 (2013). https://doi.org/10.1007/s12328-013-0420-z

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  • DOI: https://doi.org/10.1007/s12328-013-0420-z

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