A case of primary gastric choriocarcinoma and a review of the Turkish literature: An extremely rare carcinoma of the stomach

Öz

Primer mide koryokarsinomu son derece nadir ve yüksek derecede malign bir tümördür. 60 yaşında bir erkek, mide ağrısı ve siyah dışkılama şikayetleri ile başka bir hastaneye başvurmuştu. Üst gastrointestinal endoskopide mide kor-pusu ve antrumu dolduran ülserovejetan büyük bir tümör görülmüştü. Endoskopik biyopsi ile mide adenokarsinomu tanısı konulmuştu. Hasta tedavi için hastanemize kabul edildi. Kanama ile komplike olmuş mide adenokarsinomu ola-rak değerlendirildi. Cerrahi gözlemde mide korpusundan kaynaklanan kitlenin transvers kolon ve pankreasa invaze olduğu görüldü. Çölyak aksta konglomere lenfadenopatiler vardı ve çölyak damarları invaze etmiş idi. Palyasyon için subtotal gastrektomi ve genişletilmiş sağ hemikolektomi yapıldı. Patolojik incelemede sitotrofoblastlar ve sinsityotro-foblastlardan oluşan iki hücre paterninin tipik özellikleri görüldü. Tümör sadece koryokarsinomdan ibaretti. Koryokar-sinom kesin tanısı için immünohistokimyasal testler yapıldı. Beta-HCG ve EMA boyama pozitifti. Hasta ameliyattan 3 hafta sonra mide koryokarsinomu tanısı nedeniyle kontrole çağrıldı. Serum beta-HCG düzeyi458 mIU/mL idi (normal aralık,

Anahtar Kelimeler

• Koryokarsinom, mide, metastaz.

A case of primary gastric choriocarcinoma and a review of the Turkish literature: An extremely rare carcinoma of the stomach

Öz

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 occupy-ing the gastric body and antrum was seen in the upper gastrointestinal endoscopy. It was diagnosed as gastric ade-nocarcinoma 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 syncyti-otrophoblasts and cytotrophoblasts were observed. The tumor consisted of only choriocarcinoma. For the definite di-agnosis of choriocarcinoma, immunohistochemi-cal tests were performed. Beta-HCG and EMA staining were posi-tive. The patient was invited for control because of gastric choriocarcinoma three weeks later surgery. His serum be-ta-HCG level was 458 mIU/mL (normal range,

Anahtar Kelimeler

• Choriocarcinoma, stomach, metastasis.

Kaynakça

1. Berkowitz RS, Im SS, Bernstein MR, Goldstein DP. Ges- tational trophoblastic disease. Subsequent pregnancy out- come, including repeat molar pregnancy. J Reprod Med 1998;43(1):81-6.
2. Gerbie MV, Brewer JI, Tamimi H. Primary choriocarcinoma of the ovary. Obstet Gynecol 1975;46(6):720-3.
3. Schill H, Arborio M, Gros P, Grippari JL. Pathologic anatomy of tumors of the testis. Arch Anat Cytol Pathol 1992;40(4):195-201.
4. Liu Z, Mira JL, Cruz-Caudillo JC. Primary gastric chorio- carcinoma: a case report and review of the literature. Arch Pathol Lab Med 2001;125(12):1601-4.
5. Noguchi T, Takeno S, Sato T, Takahashi Y, Uchida Y, Yo- koyama S. A patient with primary gastric choriocarcinoma who received a correct preoperative diagnosis and achieved prolonged surgery. Gastric Cancer 2002;5(2):112-7.
6. Coskun M, Agildere AM, Boyvat F, Tarhan C, Niron EA. Primary choriocarcinoma of the stomach and pancreas: CT findings. Eur Radiol 1998;8(8):1425-8.
7. Gursoy M, Gur G, Ustundag Y, Demirhan B, Baysal C, Boyacioglu S. Primary gastric choriocarcinoma: A case report and review of the literature. Turk J Gastroenterol 2000;11(1):34-8.
8. Bayhan G, Yaldiz M, Yalinkaya A, Kilinc N, Gul T, Erden AC. Primary gastric choriocarcinoma: case report. Eur J Gynaecol Oncol 2000;21(3):316-7.

9. Deniz K, Taşdemir A, Patıroğlu TE. Primer gastrik koryokar- sinom: Olgu sunumu. Türk Patoloji Dergisi 2006;22(3):192- 5.
10. Kobayashi A, Hasebe T, Endo Y, et al. Primary gastric cho- riocarcinoma: two case reports and a pooled analysis of 53 cases. Gastric Cancer. 2005;8(3):178-185.
11. Yoon JH, Kim MS, Kook EH, et al. Primary gastric chorio- carcinoma: Two case report and review of the literatures. Cancer Res Treat 2008;40(3):145-50