Primary gastric choriocarcinoma: A case report

Primary gastric choriocarcinoma (PGC) is an uncommon tumor. Due to its rarity, its pathogenesis is still unclear. The diagnosis is based on immunohistopathology, which is positive for human chorionic gonadotropin (hCG). It is a highly invasive and rapidly-disseminated hematogenous neoplasm, which le...

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Detalles Bibliográficos
Autores: Barreda Bolaños, Fernando, Liu Bejarano, Humberto, Alférez Andía, Jéssica, Inoñan García, Roxana, Guerra Miller, Henry, Payet Meza, Eduardo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:Perú
Institución:Universidad de San Martín de Porres
Repositorio:Horizonte médico
Idioma:español
OAI Identifier:oai:horizontemedico.usmp.edu.pe:article/982
Acceso en línea:https://horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/982
Access Level:acceso abierto
Palabra clave:Cáncer gástrico
Coriocarcinoma
Gastrectomía
Gonadotropina coriónica
Cirugía
Stomach neoplasms
Choriocarcinoma
Gastrectomy
Chorionic gonadotropin
Surgery
Descripción
Sumario:Primary gastric choriocarcinoma (PGC) is an uncommon tumor. Due to its rarity, its pathogenesis is still unclear. The diagnosis is based on immunohistopathology, which is positive for human chorionic gonadotropin (hCG). It is a highly invasive and rapidly-disseminated hematogenous neoplasm, which leads to a poor prognosis. We present the case of a 57-year-old woman with upper gastrointestinal bleeding associated with weight loss. The gastroscopy showed, on the cardia and paracardial region, a 5x4-cm ulcerated polypoid lesion with circumscribed edges and without adjacent wall infiltration, with stigmas of recent bleeding and a pathological anatomy that demonstrates ulcerated pleomorphic malignancy with positive immunohistochemistry for pankeratin. Given the suspicion of poorly differentiated carcinoma and without evidence of metastasis, the patient underwent a total gastrectomy and the pathology was compatible with choriocarcinoma. Therefore, after the surgery, a serum hCG test was performed with a result of 714 mIU/ml, which further confirmed the diagnosis. Treatment with adjuvant chemotherapy was decided, and a tomographic and serological hCG follow-up was conducted, without the presence of active disease.