Tumor thrombus in the splenic vein originated from gastric carcinoma that produced alpha-fetoprotein.

A 72-year-old man was referred with an endoscopic diagnosis of Borrmann 2 type advanced gastric cancer. Further examination revealed tumor thrombus in the splenic vein and high serum level of alpha-fetoprotein without liver disease. Intraoperative ultrasonography revealed that tumor thrombus originated from gastric cancer extended to the splenic vein through the left gastric vein. Total gastrectomy combined with distal pancreatectomy and splenectomy was done to obtain complete resection of cancer and tumor thrombus. Tumor and its thrombus in the splenic vein were diagnosed as a poorly differentiated adenocarcinoma that produced alpha-fetoprotein. We report the case, and discuss about the gastric cancer with portal tumor thrombus and high serum levels of alpha-fetoprotein.