AFP and metastatic malignant neoplasm in the lymph nodes: These AFP-producing CRC often present with advanced disease at diagnosis, displaying a high rate of liver metastasis (up to 25%), poor differentiation (50%), deep local invasion (80%), lymph node metastasis (up to 60%), and poor prognosis [16-18]. Kong et al. reported that CRC with serum AFP ≥ 200 ng/mL are more likely to present with stage IV disease and liver metastasis compared with cases showing lower levels [17].