Primary carcinoma of the stomach is almost always adenocarcinoma or signet ring cell carcinoma and there are few reports of choriocarcinoma or neuroendocrine cell carcinoma. We report a patient with adenocarcinoma of the stomach combined with choriocarcinoma and neuroendocrine cell carcinoma. This is the first reported case of gastric cancer with these three pathological features.
A case article to be published on 28 May 2008 in the World Journal of Gastroenterology addresses this report. The research team led by Prof. Yasumitsu Hirano from Kanazawa University Graduate school of Medical Science described a patient with adenocarcinoma of the stomach combined with choriocarcinoma and neuroendocrine cell carcinoma.
They reported that a 85-year-old man presented to the hospital because of appetite loss. Gastric fiberscopy revealed a large tumor occupying the cardial region and anterior wall of the gastric body. The patient underwent total gastrectomy with lymphnode dissection and partial resection of the liver. In the gastric tumor, choriocarcinoma, small cell carcinoma and tubular adenocarcinoma were existed. The choriocarcinomatous foci contained cells positive for beta-subunit of human chorionic gonadotropin (B-hCG) and human placental lactogen mainly in syncytiotrophoblastic cells. The small cell carcinomatous foci contained cells positive for synaptophysin, neuron-specific enolase (NSE), and chromogranin A.
The prognosis for gastric adenocarcinoma with choriocarcinoma and neuroendocrine cell carcinoma is exceedingly poor. This patient died about 2 month after the first complaint from hepatic failure. This is the first reported case of gastric cancer with these three pathological features.