A 71-year-old man was admitted to our hospital with edema of the ambilateral crura and liver dysfunction. Serum levels of AFP and PIVKA-II were both abnormally high. An abdominal CT revealed many low density masses in both lobes of the liver. Endoscopic examination and gastric radiography showed a Type 1 tumor in the fornix of the stomach. Biopsy specimen showed poorly differentiated adenocarcinoma. Immunohistochemical stains demonstrated the presence of AFP and PIVKA-II in tumor cells. A diagnosis of AFP and PIVKA-II producing gastric carcinoma with liver metastasis was made and the internal use of S-1 was started. The result of treatment was determined to be partial response. However, the condition of his entire body gradually worsened and he died of hepatic insufficiency.
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