Author/Authors :
Kırkıl, Cüneyt Fırat University - Medical School - Department of General Surgery, Turkey , Karabulut, Koray Firat University - Faculty of Medicine - Department of General Surgery, Turkey , Aygen, Erhan Firat University - Faculty of Medicine - Department of General Surgery, Turkey , İlhan, Yavuz Selim Firat University - Faculty of Medicine - Department of General Surgery, Turkey , Yur, Mesut Fırat University - Medical School - Department of General Surgery, Turkey , Özercan, İbrahim Hanifi Firat University - Faculty of Medicine - Department of Pathology, TURKEY
Abstract :
Primary choriocarcinoma of the stomach is an extremely rare and highly malignant tumor. A 60 years old man visited another hospital for the chief complaint of the stomachache and black stools. A large ulcero-vegetative tumor occupying the gastric body and antrum was seen in the upper gastrointestinal endoscopy. It was diagnosed as gastric adenocarcinoma by endoscopic biopsy. The patient admitted to our hospital for treatment. The patient was assessed as a gastric adenocarcinoma complicated with hemorrhage. In the exploration, it was observed that the mass arising from gastric body was invaded the transverse colon and pancreas. The lymphadenopaties in the celiac axis were conglomerated and had invaded the celiac vessels. A subtotal gastrectomy and an extended right hemicolectomy were performed for palliation. In pathological findings, typical characteristics of two cell pattern consisting of syncytiotrophoblasts and cytotrophoblasts were observed. The tumor consisted of only choriocarcinoma. For the definite diagnosis of choriocarcinoma, immunohistochemi-cal tests were performed. Beta-HCG and EMA staining were positive. The patient was invited for control because of gastric choriocarcinoma three weeks later surgery. His serum beta-HCG level was 458 mIU/mL (normal range, 0.5 mIU/mL). For the differantiation from the primary choriocarcinoma in the testis or mediastinum, testicular ultrasonography and chest CT were performed. Abnormal findings were not detected in the tests, so it was diagnosed as primary gastric choriocarcinoma. The patient refused chemotherapy. Three months later, he had inguinal lymphadenopaties and multiple metastases in lung. He died 5 months after surgery because of respiratory failure.
