Primary gastric choriocarcinoma: a case report and review of the literature.
Choriocarcinoma is a rapidly invasive, widely metastatic human chorionic gonadotropin (HCG)-producing neoplasm, usually intrauterine and gestational. Primary gastric choriocarcinoma is very rare, and its pathogenesis is still uncertain. We report a case of primary gastric choriocarcinoma associated with adenocarcinoma in a 36-year-old woman. The patient presented with gastrointestinal bleeding and a gastric mass clinically suspicious of gastric adenocarcinoma. Histopathologic evaluation proved the tumor to be a choriocarcinoma, with a minor component of a poorly differentiated adenocarcinoma. The patient was treated with a standard nongestational choriocarcinoma chemotherapy regimen. An impressive initial response was evidenced by clinical reduction of the tumor volume and drop of the serum beta-HCG levels after the first cycle. However, the tumor rapidly recurred in the abdomen and disseminated to the lungs, which were documented by new elevation of serum beta-HCG levels and computed tomographic scans despite continuing with 3 more cycles of chemotherapy. The patient died 6 months after diagnosis.
Liu
Z
Z
Department of Pathology, Texas Tech University, Health Science Center, Lubbock, 79430, USA.
Mira
J L
JL
Cruz-Caudillo
J C
JC
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002822:Choriocarcinoma / Q000097:blood / Q000188:drug therapy / Q000556:secondary*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy / Q000556:secondary*; D009364:Neoplasm Recurrence, Local; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D018997:Chorionic Gonadotropin, beta Subunit, Human; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin