Markedly increased alpha-fetoprotein concentration in serum in alcoholic liver disease: malignant tumor or nonneoplastic changes?

We present a patient with a history of alcohol abuse who was admitted to a hospital in poor condition. His serum concentration of alpha-fetoprotein was markedly increased [initially 1400 kilo-int. unitsfL, after four months 6600 kilo-mt. unita/L (-1700 and 7900 .tg/L, respectively)]. This finding led us to suspect the presence of a liver tumor, which was supported by ultrasonographic examination. However, further evaluation did not confirm the contention of hepatic malignancy at that time. We discuss possible mechanisms for an increase in serum alpha-fetoprotein concentration in nonneoplastic liver disorders and suggest investigations that may lead to a better understanding of such cases.