{"id":1784,"date":"2004-10-01T01:00:00","date_gmt":"2004-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/tumeur-hepatique-et-elevation-de-lalfa-foeto-proteine-il-faut-faire-une-gastroscopie-l-girondengo-m-picon-j-lafon\/"},"modified":"2018-10-20T18:39:34","modified_gmt":"2018-10-20T16:39:34","slug":"tumeur-hepatique-et-elevation-de-lalfa-foeto-proteine-il-faut-faire-une-gastroscopie-l-girondengo-m-picon-j-lafon","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/tumeur-hepatique-et-elevation-de-lalfa-foeto-proteine-il-faut-faire-une-gastroscopie-l-girondengo-m-picon-j-lafon\/","title":{"rendered":"TUMEUR H\u00e9PATIQUE ET \u00e9L\u00e9VATION DE L\u2019ALFA FOETO PROT\u00e9INE : IL FAUT FAIRE UNE GASTROSCOPIE !\nL. GIRONDENGO ; M. PICON ; J. LAFON"},"content":{"rendered":"<p><strong>2004<\/strong><\/p>\n<p><em>L. GIRONDENGO ; M. PICON ; J. LAFON<\/em><\/p>\n<p><strong>Gastroent\u00e9rologie <\/strong>&#8211; \u00a00000-00-00 &#8211;\u00a0CO &#8211;<\/p>\n<p>________________________________<\/p>\n<p>L\u2019alfa foeto prot\u00e9ine est une glycoprot\u00e9ine dont l\u2019\u00e9l\u00e9vation est classiquement associ\u00e9e aux h\u00e9patopathies.<br \/>\nBien qu\u2019un taux \u00e9lev\u00e9 puisse se voir dans des tumeurs testiculaires ou rarement dans des tumeurs digestives (carcinome pancr\u00e9atique, tumeur des voies biliaires), une franche \u00e9l\u00e9vation oriente en premier lieu vers un carcinome h\u00e9patocellulaire, le plus souvent d\u00e9velopp\u00e9 sur cirrhose.<\/p>\n<p>Nous rapportons l\u2019observation d\u2019un homme de 61 ans sans ant\u00e9c\u00e9dents pr\u00e9sentant une volumineuse l\u00e9sion h\u00e9patique unique associ\u00e9e \u00e0 une \u00e9l\u00e9vation de l\u2019AFP \u00e0 10 fois la normale.<br \/>\n7 mois apr\u00e8s h\u00e9patectomie droite \u00e9largie au segment IV, le patient a pr\u00e9sent\u00e9 une l\u00e9sion du tiers inf\u00e9rieur de l\u2019\u0153sophage, qui s\u2019est r\u00e9v\u00e9l\u00e9 \u00eatre de m\u00eame nature : un ad\u00e9nocarcinome papillaire.<\/p>\n<p>Les tumeurs gastriques s\u00e9cr\u00e9tant de l\u2019alfa foeto prot\u00e9ines sont des tumeurs rares dont la premi\u00e8re description remonte \u00e0 1970 (1). Depuis,  cette entit\u00e9 \u00e0 fait l\u2019objet de plusieurs publications, notamment aux \u00e9tats unis et au japon. En 1985, un auteur japonais, Ishikura,  \u00e0 d\u00e9fini ces l\u00e9sions sous le terme de \u00ab tumeurs h\u00e9pato\u00efdes de l\u2019estomac \u00bb(2). Morphologiquement, il existe 2 types histologiques d\u2019ad\u00e9nocarcinomes h\u00e9pato\u00efdes : le premier de type m\u00e9dullaire, proche de l\u2019architecture du carcinome h\u00e9patocellulaire, le second bien diff\u00e9renci\u00e9, de type papillaire ou tubulaire, avec des cellules \u00e0 cytoplasme clair (3).<br \/>\nL\u2019int\u00e9r\u00eat de notre cas clinique est la pr\u00e9sentation clinique peu typique (masse unique m\u00e9tastatique de 3.6 kg sans aucun sympt\u00f4me digestif haut), et la localisation oesophagienne qui est exceptionnelle (3 cas de tumeur h\u00e9pato\u00efde oesophagienne d\u00e9cris) (4,5,6).<\/p>\n<p>R\u00e9f\u00e9rences.<\/p>\n<p>1. Boureille J, M\u00e9tayer P, Sanger F, Matray F, Fondimare A Existence d\u2019alfa foeto proteine au cours d\u2019un cancer secondaire du foie d\u2019origine gastrique. Presse Med 1970 ; 78 : 1277<br \/>\n2. Ishikura H, Fukasawa Y, Ogasawara K, Natoti T, Tsukada Y An AFP-producting gastric carcinoma with features of hepatic differentiation : a case report. Cancer 1985 ; 56 : 840-8<br \/>\n3. Kodama T, Kameya T, Hirota T. Production of AFP, normal serum proteins, and human choriogenic gonadotropin in stomach cancer : histologic and immuno-histochemical analyses of 35 cases . Cancer 1981 ; 48 : 1647-55.<br \/>\n4. Motoyama T, higuchi M, Taguchi J, Combined choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma in the oesophagus. Virchows Arc 1995 ; 427 : 451-4<br \/>\n5. Tanigawa H, Kida y, Kuwao S, Uesugi H Ojima T, Kobayashi N. Hepatoid adenocarcinoma in Barrett\u2019s oesophagus associated with achalasia : first case report. Pathol Int 2002 ; 52 : 141-6<br \/>\n6. Sockeel P, Abbey-toby A, Regimbeau JM, Cazals-Hatem D, Belghuiti J, Sauvanet A.Adenocarcinome hepatoide du bas \u0153sophage. Gastroenterol Clin Biol 2004 ; 28 : 84-96<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2004 L. GIRONDENGO ; M. PICON ; J. LAFON Gastroent\u00e9rologie &#8211; \u00a00000-00-00 &#8211;\u00a0CO &#8211; ________________________________ L\u2019alfa foeto prot\u00e9ine est une glycoprot\u00e9ine dont l\u2019\u00e9l\u00e9vation est classiquement associ\u00e9e aux h\u00e9patopathies. Bien qu\u2019un taux \u00e9lev\u00e9 puisse se voir dans des tumeurs testiculaires ou rarement dans des tumeurs digestives (carcinome pancr\u00e9atique, tumeur des voies biliaires), une franche \u00e9l\u00e9vation oriente [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[15],"class_list":["post-1784","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-15"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>TUMEUR H\u00e9PATIQUE ET \u00e9L\u00e9VATION DE L\u2019ALFA FOETO PROT\u00e9INE : IL FAUT FAIRE UNE GASTROSCOPIE ! L. GIRONDENGO ; M. PICON ; J. 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