Primary gastric choriocarcinoma-a rare and aggressive tumor with multilineage differentiation: A case report  

作　　者：Simona Gurzu Constantin Copotoiu Alexandra Tugui Cedric Kwizera Rita Szodorai Ioan Jung 

机构地区：[1]Department of Pathology,University of Medicine,Pharmacy,Sciences and Technology,Targu Mures 530149,Romania [2]Research Center (CCAMF),University of Medicine,Pharmacy,Sciences and Technology,Targu Mures 540139,Romania [3]Department of Surgery,University of Medicine,Pharmacy,Sciences and Technology,Targu Mures 530149,Romania

出　　处：《World Journal of Clinical Cases》2019年第14期1837-1843,共7页世界临床病例杂志

基　　金：Supported by a grant of the Romanian National Authority for Scientific Research,CNCS–UEFISCDI,No.20 PCCF/2018,code:PN-III-P4-ID-PCCF-2016-0006

摘　　要：BACKGROUND Primary choriocarcinoma of the stomach (PCCS) is a rare tumor, with fewer than 60 cases published in the English-language literature up to December 2018. In this paper, we present the complex immunoprofile of one PCCS and a hypothesis regarding its histogenesis. CASE SUMMARY A 66-year-old previously healthy male underwent an emergency palliative gastrectomy for a gastric obstructive tumor. The histologic examination and immunoprofile of tumor cells showed a mixed tumor that consisted of choriocarcinoma (90%) and moderate differentiated adenocarcinoma (10%), with hepatic metastases (Stage pT2NxM1L1V1R0) and microsatelite stable status. The patient died one month after surgery. The tumor cells showed focal positivity for CDX2 (adenocarcinoma component), HCG (choriocarcinoma) and CD138 (plasmacytoid carcinoma component) and were negative for HER-2,α- fetoprotein, VEGF, maspin and markers of epithelial-mesenchymal transition. The gastric mucosa cells displayed positivity for CDX2, Hepar A and CD138. The complex immunoprofile and literature data synthesis prove that the gastric mucosa cells can present a multilineage differentiation. CONCLUSION PCCS should be considered as an aggressive variant of microsatellite stable gastric adenocarcinoma of an epithelial type, and not a germ cell tumor.BACKGROUND Primary choriocarcinoma of the stomach(PCCS) is a rare tumor, with fewer than 60 cases published in the English-language literature up to December 2018. In this paper, we present the complex immunoprofile of one PCCS and a hypothesis regarding its histogenesis.CASE SUMMARY A 66-year-old previously healthy male underwent an emergency palliative gastrectomy for a gastric obstructive tumor. The histologic examination and immunoprofile of tumor cells showed a mixed tumor that consisted of choriocarcinoma(90%) and moderate differentiated adenocarcinoma(10%), with hepatic metastases(Stage pT2NxM1L1V1R0) and microsatelite stable status. The patient died one month after surgery. The tumor cells showed focal positivity for CDX2(adenocarcinoma component), HCG(choriocarcinoma) and CD138(plasmacytoid carcinoma component) and were negative for HER-2, α-fetoprotein, VEGF, maspin and markers of epithelial-mesenchymal transition.The gastric mucosa cells displayed positivity for CDX2, Hepar A and CD138. The complex immunoprofile and literature data synthesis prove that the gastric mucosa cells can present a multilineage differentiation.CONCLUSION PCCS should be considered as an aggressive variant of microsatellite stable gastric adenocarcinoma of an epithelial type, and not a germ cell tumor.

关 键 词：CHORIOCARCINOMA STOMACH GASTROINTESTINAL IMMUNOHISTOCHEMISTRY MASPIN Case report 

分 类 号：R[医药卫生]