Korean J Gastroenterol.  2019 Jun;73(6):350-354. 10.4166/kjg.2019.73.6.350.

Primary Gastric Choriocarcinoma Coexisting with Adenocarcinoma

• Lee JH
• Lee JK
• Kang DB

• KMID: 2454096
• DOI: http://doi.org/10.4166/kjg.2019.73.6.350

Abstract

Choriocarcinoma is an aggressively growing and widely metastasizing tumor that originates from trophoblastic cells. A primary gastric choriocarcinoma (PGC), however, is very rare. A 76-year-old female patient visited the emergency department of Wonkwang University Hospital with abdominal discomfort and melena. Esophagogastroduodenoscopy revealed a huge ulceroinfiltrative mass lesion with blood clots on the boundary between the greater curvature side and the posterior wall side of the stomach lower body. CT showed a 3-cm exophytic mass lesion with heterogeneous enhancement, an ulcer lesion at the posterior wall side of the stomach lower body, and multiple enlarged lymph nodes at the splenic artery and left gastric artery nodal stations. She underwent a radical subtotal gastrectomy with a D2 lymph node dissection. The final diagnosis was PGC coexisting with adenocarcinoma based on the pathology results. This paper reports a rare case of primary gastric choriocarcinoma coexisting with adenocarcinoma and discusses the characteristics of this neoplasm with reference to the literature.

Keyword

Stomach; Choriocarcinoma; Adenocarcinoma; Chorionic gonadotropin

MeSH Terms

Adenocarcinoma*
Aged
Arteries
Choriocarcinoma*
Chorionic Gonadotropin
Diagnosis
Emergency Service, Hospital
Endoscopy, Digestive System
Female
Gastrectomy
Humans
Lymph Node Excision
Lymph Nodes
Melena
Pathology
Pregnancy
Splenic Artery
Stomach
Trophoblasts
Ulcer
Chorionic Gonadotropin

Figure

• 

  Fig. 1 Esophagogastroduodenoscopy findings. A huge ulceroinfiltrative mass lesion with blood clots on the boundary between the greater curvature side and the posterior wall side of the stomach lower body.

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  Fig. 2 Abdomen-pelvic computed tomography findings. A 3-cm exophytic mass lesion with heterogeneous enhancement, ulcer lesion at the posterior wall side of the stomach lower body, and multiple enlarged lymph nodes at the splenic artery and left gastric artery nodal stations (white arrow).

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  Fig. 3 (A) Pathology results. There was choriocarcinoma (black arrow) coexisting with well-differentiated tubular adenocarcinoma (white arrow) (H&E, ×40). (B) Choriocarcinoma component consisted of highly pleomorphic, bizarre cells with cytotrophoblastic and syncytiotrophoblastic differentiation (H&E, ×100). (C) Choriocarcinoma component was highly positive for β-human chorionic gonadotropin (immunohistochemical staining, ×40).

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