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A coexistent case of primary gastric choriocarcinoma and alpha fetoprotein-producing gastric cancer which caused rapid postoperative progression

Japanese Journal of Gastroenterological Surgery, ISSN: 0386-9768, Vol: 44, Issue: 12, Page: 1535-1542
2011
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    Citations
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Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    3
    • Citation Indexes
      3
      • CrossRef
        3

Article Description

We report a case of primary gastric choriocarcinoma admixed with an alpha-fetoprotein (AFP)-producing gastric cancer, which showed rapid progress after surgery. A 78-year-old woman was hospitalized for gastric cancer in the upper stomach. Abdominal computed tomography detected the upper gastric tumor and the swelling of adjacent lymph nodes. Initial laboratory data showed high level of serum AFP (166 ng/ml). We performed total gastrectomy with resection of pancreatic tail and spleen. His-logy confirmed the tumor consisted of two components: primary gastric choroiocarcinoma (PGC) and yolk sac tumor-like AFP-producing gastric cancer. Pathological staging was pT2N2M0 and Stage IIIA. The patient suffered immunocompromised status after surgery, and died because of infectious endocarditis on the 48th postoperative day. Although an autopsy revealed many small tumor thromboses in the intrahepatic portal vein, there is no evidence of metastasis in other organ. Primary gastric chorio-carcionma is very rare and extremely malignant. Furthermore there are few reports of the coexistence case with yolk sac tumor-like gastric cancer; this case suggested that a retrodifferentiation of the gastric adenocarcioma caused two types of embryonic cancer-like components. The autopsy revealed small tumor thromboses in the liver which were not detected by enhanced CT. This finding would be helpful to determine the treatment strategy. © 2011 The Japanese Society of Gastroenterological Surgery.

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