Background Alpha-fetoprotein is produced by a number of tumors such as for example hepatocellular carcinoma, hepatoblastoma, and germ cell tumors from the ovary and testes. liver organ function, positivity for hepatitis B e antigen, and a designated increase in hepatitis B virus deoxyribonucleic acid copy number (>7 105 IU/mL). Our patient was diagnosed with acute exacerbation of chronic hepatitis B, and we presumed that this condition might be related to extremely elevated alpha-fetoprotein. When our patient was treated with entecavir, the serum alpha-fetoprotein level immediately decreased, in parallel with the hepatitis B virus deoxyribonucleic acid copy number. Conclusions We report a rare case of extremely elevated alpha-fetoprotein due to acute exacerbation of chronic hepatitis B without any malignancy, and a decrease in this tumor marker simultaneous with a decrease in hepatitis B virus deoxyribonucleic acid copy number on entecavir treatment. This case report is important due to the rarity of the case; furthermore, it provides HOE-S 785026 supplier details of a diagnostic process for a variety of benign diseases and malignant tumors that should be considered in patients with elevated alpha-fetoprotein. Thus, we present a case report, along with a review, that will be helpful for diagnosis and treatment of patients with elevated alpha-fetoprotein. Keywords: -Fetoprotein, Tumor markers, Hepatitis B, Hepatocellular carcinoma, Testicular cancer Background Serum tumor markers (STMs) are widely used in clinical settings as effective indicators for screening of malignant tumors, diagnosis of tumor type, establishing a prognosis, analyzing treatment effects, and early detection of relapse. Although the roles of STMs are limited in many cases, owing to their varying sensitivity and specificity, when STM values are markedly elevated, the corresponding cancer is strongly suspected [1]. In particular, alpha-fetoprotein (-FP) is a key marker in screening for liver cancer in high-risk patient groups [2, 3]. Case presentation A 60-year-old Korean man was admitted to our institution due to elevated -FP discovered during a wellness screening examination. He previously been identified as having chronic hepatitis B 6 years and received regular follow-up observations previous; however, he previously not been recommended any medicine, as no irregular findings connected with signals of energetic hepatitis, cirrhosis, or liver organ cancer were found out. Furthermore, our patient hadn’t received an stomach ultrasound exam or a bloodstream test before 24 months. Our patient demonstrated a highly raised -FP degree of 2350 ng/mL (regular; <5 ng/mL), along with raised aspartate aminotransferase (AST), 201 U/L (5C40 U/L), alanine aminotransferase (ALT), 209 U/L (5C40 U/L), total bilirubin, 1.91 mg/dL (0.2C1.2 mg/dL), immediate bilirubin, 1.3 mg/dL, alkaline phosphatase, 100 U/L (35C123 U/L), and gamma-glutamyl transpeptidase, (r-GTP) 256 U/L (15C73 Rabbit Polyclonal to NPHP4 U/L). Our affected person got no background of acquiring natural or traditional Korean medications or traditional western medications, and no history of infection or travel. Although our patient was considered to be at high risk for liver cancer because he was a carrier of chronic hepatitis B, no liver tumors were observed on the abdominal ultrasound image; however, splenomegaly accompanied by moderate cirrhosis was found. Interventional dynamic computed tomography (CT) was performed on his chest, abdomen, and pelvis for precision testing of the liver parenchyma and assessment of cancers that typically show elevated -FP, such as testicular cancer and germ cell cancer, along with paraneoplastic syndrome, which also results in secretion of -FP. However, the findings again indicated only cirrhosis, as no tumor or lymphadenopathy was observed in the liver parenchyma, chest, abdomen, or pelvis. Furthermore, there have been no specific results from a accuracy urological physical exam and a testicular ultrasound scan. Furthermore, gastric endoscopy was performed to HOE-S 785026 supplier check for -FP-secreting hepatoid gastric adenocarcinoma, a common gastric tumor in Korea that’s known to possess an unhealthy prognosis; nevertheless, no malignancy was recognized. Additional tumor markers, such HOE-S 785026 supplier as for example beta-human chorionic gonadotropin (-HCG) <1.20 mIU/mL (0C1.25 mIU/mL), proteins induced by vitamin K absence or antagonist-II (PIVKA-II) 11 mAU (0C39 mAU), and carcinoembryonic antigen (CEA) 2.8 ng/mL (0C5 ng/mL), had been all within the standard range. Precision tests for hepatitis was performed because our individual had a brief history of chronic hepatitis B and demonstrated raised AST and ALT. The test outcomes had been hepatitis B surface area antigen positive (HBsAg+), hepatitis B e antibody adverse (HBsAb?), and.