AFP-producing Squamous Cell Carcinoma of the Lung in an Adolescent

We report a case of primary lung cancer in a 16-year-old boy.A histologic diagnosis of squamous cell carcinoma was made bybronchoscopic biopsy before surgery. The serum alpha-fetoprotein(AFP) level was markedly elevated at 193 ng/dl. Preoperativeand postoperative evaluation revealed no evidence of scrotalmass. We performed right pneumonectomy with combined resectionof the invaded portion of the left atrium under extracorporealcirculation. Despite the rapid improvement in the patient'sgeneral condition after surgery, the AFP level continued toincrease without a transient decrease and reached 3160 ng/mlon the 23rd postoperative day. When the patient was readmittedbecause of dyspnea and headache on the 36th postoperative day,hypercalcemia of 13.9 mg/dl was noted, and this was resistantto subsequent treatment. The patient died on the 46th postoperativeday.