CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Recurrence of Gastric Cancer with Krukenberg Tumor, Presenting with a High Alpha-fetoprotein Level, A Case Report
Provisionally accepted
Elif Haznedaroglu Benlioglu*
Samed Rahatli
Seyfettin BaltaciogluMehmet Burkay Karakulak
Efe YetisginMustafa Altinbas- Ankara Etlik City Hospital, Ankara, Türkiye
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
INTRODUCTION Gastric cancer is a globally common malignancy which has a high mortality rate (1). Despite advances in diagnosis and treatment, diagnoses at advanced stages are common, which leads to a poor prognosis (2). Alpha-fetoprotein is a glycoprotein which is normally found in the fetal liver and yolk sac (3). Elevation of alpha-fetoprotein level is considered abnormal in adults, and it is a distinct tumor marker for yolk sac tumor and hepatocellular carcinoma (4). Alpha-fetoprotein level was also shown to be produced in colorectal cancer and lung cancer (5-8). Various case reports, case series and studies show elevated serum alpha-fetoprotein as a significant biomarker in gastric cancer, correlating especially with liver metastases, venous invasion, lymphatic invasion and an overall poorer prognosis (9-12). Krukenberg tumor, the metastatic spread of gastric adenocarcinoma to the ovary, is an uncommon yet clinically critical presentation of late-stage disease (13). This case report details the presentation, diagnosis, and management of a 30-year-old female patient with gastric adenocarcinoma that metastasized to the ovaries, uniquely characterized by a significant elevation in serum AFP levels. This case underscores the importance of considering rare metastatic patterns and atypical tumor marker elevations in the comprehensive evaluation and management of gastric cancer patients.
Keywords: Alpha fetoprotein (AFP), gastric cancer, Krukenberg metastases, Metastatic gastric cancer, Ovarian metastases
Received: 31 Jul 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Haznedaroglu Benlioglu, Rahatli, Baltacioglu, Karakulak, Yetisgin and Altinbas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Elif Haznedaroglu Benlioglu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.