Rapid recurrence of primary gastric choriocarcinoma after complete resection.
Primary gastric choriocarcinoma
Short-term survival
Total gastrectomy
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2019
2019
Historique:
received:
25
12
2018
revised:
18
03
2019
accepted:
24
03
2019
pubmed:
9
4
2019
medline:
9
4
2019
entrez:
9
4
2019
Statut:
ppublish
Résumé
Primary gastric choriocarcinoma (PGC) is a rare and rapidly invasive tumor. We report a case of PGC diagnosed by endoscopic biopsy and treated with gastrectomy and chemotherapy. A 78-year-old man was referred to our hospital because esophagogastroduodenoscopy showed a tumor at the fornix of the stomach. Pathologic examination of biopsy specimens revealed choriocarcinoma. Abdominal computed tomography (CT) revealed no enlarged abdominal lymph nodes or distant metastases. Robot-assisted total gastrectomy with spleen-preserving D2 lymphadenectomy was performed on the basis of a diagnosis of cT2N0M0, stage cIB PGC. The pathologic diagnosis was pT2, ly0, v1, pN0, PM0, DM0, stage pIB PGC. The postoperative course was uneventful, and the patient was followed carefully without adjuvant chemotherapy. Three months after gastrectomy, blood tests indicated that serum β-human chorionic gonadotropin (β-hCG) levels had increased, and CT revealed multiple liver metastases. The patient underwent a standard nongestational choriocarcinoma chemotherapy regimen with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine. Although β-hCG levels temporarily decreased with chemotherapy, the patient experienced tumor recurrence with ascites and his serological test demonstrated an elevated level of β-hCG (120 ng/mL). The patient died 10 months postoperatively. We report a case of stage pIB PGC with poor prognosis, recurring at only 3 months postoperatively despite curative surgery and chemotherapy.
Identifiants
pubmed: 30959361
pii: S2210-2612(19)30165-8
doi: 10.1016/j.ijscr.2019.03.045
pmc: PMC6453829
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
138-141Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
Références
South Med J. 2000 Feb;93(2):226-8
pubmed: 10701796
Indian J Pathol Microbiol. 2000 Oct;43(4):471-4
pubmed: 11344617
Gastric Cancer. 2002;5(2):112-7
pubmed: 12111588
Nihon Shokakibyo Gakkai Zasshi. 2002 Dec;99(12):1460-5
pubmed: 12518395
Cancer. 1953 Mar;6(2):319-26
pubmed: 13032923
Gastric Cancer. 2005;8(3):178-85
pubmed: 16086121
Singapore Med J. 2008 Oct;49(10):e286-8
pubmed: 18946601
Oman Med J. 2010 Oct;25(4):303-5
pubmed: 22043363
Gan No Rinsho. 1990 Aug;36(9):1025-30
pubmed: 2381047
Ann Oncol. 2013 Oct;24 Suppl 6:vi39-50
pubmed: 23999759
Oman Med J. 2016 Sep;31(5):381-3
pubmed: 27602194
Int J Surg. 2018 Dec;60:132-136
pubmed: 30342279
Am J Gastroenterol. 1988 Oct;83(10):1172-5
pubmed: 3048084
Virchows Arch A Pathol Anat Histol. 1982;396(2):141-53
pubmed: 6750912
Am J Surg Pathol. 1981 Jun;5(4):333-42
pubmed: 7196700