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KMID : 0371320030650040356
Journal of the Korean Surgical Society
2003 Volume.65 No. 4 p.356 ~ p.360
Primary Gastric Choriocarcinoma



Abstract
A choriocarcinoma is a rapidly invasive, widely metastatic, human chorionic gonadotropin (HCG)-producing neoplasm, which are usually intrauterine and gestational. A primary gastric choriocarcinoma is very rare, and its pathogenesis is still uncertain. A 56-year old man presented with gastrointestinal bleeding and a gastric mass, clinically suspicious of a gastric adenocarcinoma. Thus, a radical subtotal gastrectomy a lmymph node dissection, with a reconstruction, was performed. The resected specimen was found to be a Borrmenn type ¥° tumor, and a histological examination showed it to be a primary gastric choriocarcinoma, with an associated adenocarcinoma and a syncytiotrophoblast, which was immunostained by human chorionic gonadotropin (HCG). The serum HCG level, on the 7^(th) postoperative day, was found to be 2,775 mlU/ml. Chemotherapy was administered two months after surgery, as the patient refused chemotherapy during the immediate post operative period. At that time, the tumor rapidly recurred and disseminated to the liver. The patient died three months after the initial diagnosis.
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