Abstract
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 ofa 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 pleomorphicmalignancy 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, whichfurther 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.
Highlights
Primary gastric choriocarcinoma (PGC) is an uncommon tumor
Paciente mujer de 57 años, natural y procedente de Cusco (Perú), sin antecedentes de importancia
ORCID iDsFernando barreda Bolaños Humberto Liu Bejarano Jéssica Alférez Andía Roxana Inoñan García Henry Guerra Miller Eduardo Payet Meza https://orcid.org/0000-0002-7923-6299 https://orcid.org/0000-0002-8417-0837 https://orcid.org/0000-0002-1314-1422 https://orcid.org/0000-0002-8866-915X https://orcid.org/0000-0002-4894-5631 https://orcid.org/0000-0001-9434-3888
Summary
Fernando Barreda Bolaños* 1,a; Humberto Liu Bejarano 1,a; Jéssica Alférez Andía 2,b; Roxana Inoñan García 3,b; Henry Guerra Miller 1,c; Eduardo Payet Meza 1,d. El diagnóstico se basa en la inmunohistopatología, la cual es positiva para gonadotropina coriónica humana (hCG). A nivel de cardias y región paracardial, lesión polipoidea ulcerada de 5x4 cm, con bordes circunscritos y sin presencia de infiltración de pared adyacente, con estigmas de sangrado reciente y anatomía patológica que informa neoplasia maligna pleomórfica ulcerada con inmunohistoquímica positiva para panqueratina. Ante la sospecha de carcinoma poco diferenciado y sin evidencia de metástasis, la paciente fue sometida a gastrectomía total y la patología fue compatible con coriocarcinoma. Posterior a la cirugía, se realiza estudio de hCG sérico con resultado de 714 mIU/ml, lo que confirmó aún más el diagnóstico. Palabras clave: Cáncer gástrico; Coriocarcinoma; Gastrectomía; Gonadotropina coriónica; Cirugía (Fuente: DeCS BIREME)
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