A Coexistent Case of Primary Gastric Choriocarcinoma and Alpha Fetoprotein-producing Gastric Cancer which Caused Rapid Postoperative Progression

Sasaki, Naoya; Shirakata, Yoshiharu; Shinohara, Hisashi; Itoi, Kazumi; Maki, Atsuhiko; Mizuno, Yoshifumi; Mimura, Rokuro; Takasu, Koushou

doi:10.5833/jjgs.44.1535

Cited by 3 publications

(2 citation statements)

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“…Extragonadal choriocarcinomas have been reported to occur in testes, pineal gland, lungs, mediastinum and retroperitoneum and its incidence has been reported to be 2-5% of all choriocarcinomas in males [1]. A primary choriocarcinoma of the gastrointestinal tract is rare and even the most frequent primary gastric choriocarcinomas have been reported to arise in approximately 0.08% of stomach malignant tumors [2][3][4]. Primary esophageal choriocarcinomas are extremely rare and only nine cases worldwide have been reported to have occurred after 1970 [5][6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Choriocarcinomas often occur in the gonads, uterus, mediastinum and retroperitoneum [1]. Primary choriocarcinomas in the gastrointestinal tract are rare, especially primary esophageal choriocarcinomas, which are extremely rare [2][3][4][5][6][7][8][9][10][11][12][13]. We report the world's first resected case of a primary esophageal choriocarcinoma combined with squamous cell carcinoma (SCC)-like components in association with Barrett's adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

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Surgically resected primary esophageal choriocarcinoma accompanied with Barrett’s adenocarcinoma: a case report

et al. 2020

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Background Choriocarcinomas are usually classified as either gestational or non-gestational. Primary choriocarcinomas in the gastrointestinal tract, especially primary choriocarcinomas in the esophagus, are extremely rare. We report a case of a rare primary esophageal choriocarcinoma mixed with squamous cell carcinoma-like components in association with Barrett’s adenocarcinoma. Case presentation A 58-year-old man visited the hospital, complaining of hematemesis and tarry stools. In emergency upper gastrointestinal endoscopy, a bleeding esophageal tumor was observed. Additionally, a contrast computed tomography (CT) scan showed a large hypervascular tumor 4.8 cm in diameter in the left kidney. He came to our institution for further examination and treatment of the esophageal tumor and kidney lesion. The patient had an easy bleeding elevated tumor 2 cm in diameter at the left wall of the middle thoracic esophagus and a left renal carcinoma. Histopathological diagnosis of the biopsy specimen of the esophageal tumor was a poorly differentiated carcinoma. However, a precise histological type diagnosis could not be obtained. In June 2016, mediastinoscopic transhiatal esophagectomy and posterior mediastinal gastric tube reconstruction were performed to treat his esophageal tumor. Histopathologically, most of the tumor comprised hCG-positive syncytiotrophoblasts. Therefore, we confirmed it as a primary esophageal choriocarcinoma. Furthermore, the tumor contained a poorly differentiated squamous cell carcinoma-like component that was also diagnosed as a choriocarcinoma using immunohistochemical staining and there was a small Barrett’s esophageal adenocarcinoma lesion in the Barrett's epithelium near the tumor. Three months after surgery, a CT scan demonstrated multiple lung metastatic nodules and multiple intrahepatic masses. Needle biopsy from the lung nodule showed a choriocarcinoma. Despite chemotherapy, the metastatic choriocarcinoma regrew rapidly and multiple bone metastases appeared. He died because of his esophageal choriocarcinoma 13 months after primary resection. Conclusions We encountered an extremely rare case of esophageal choriocarcinoma combined with squamous cell carcinoma-like components in association with a simultaneous Barrett’s adenocarcinoma that we followed for the entire course of his disease, from resection to end of life. Esophageal choriocarcinomas are rare with peculiar characteristics and very poor prognoses. Additional cases are needed to establish an appropriate future treatment.

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