Clin Case Rep Int | Volume 4, Issue 1 | Case Report | Open Access
Noriaki Kojima1 and Hideki Mori2*
1Department of Surgery, Ogaki Tokusyukai Hospital, Japan 2Department of Diagnostic Pathology, Ogaki Tokusyukai Hospital, Japan
*Correspondance to: Hideki MoriFulltext PDF
Seventy eight-years-old female Japanese having simultaneous occurrence of a carcinoma in the lower gastric body and another carcinoma in the posterior wall of the pylorus received a distal gastrectomy in our hospital. Histology of the tumor in the lower gastric body was adenocarcinoma with papillary or tubular structures in the mucosal area. However, in the submucosal area, majority of tumor cells was changed to clear cells resembling cytotrophoblasts as seen in trophoblastic neoplasms. Furthermore, solitary growth of the spindle cells resembling Syncytiotrophoblast cells was apparent in the layers of muscularis propria and subserosa. Immunohistochemically, syncytiotrophoblast type cells were positive for beta-subunit of Human Chorionic Gonadotropin (HCG). Three out of 28 regional lymph nodes had metastases of the neoplasm with adenocarcinoma as well as choriocarcinomatous components. The tumor on the posterior wall of pylorus was a tubular adenocarcinoma only recognized in the mucosal layer. The tumor did not contain any trophoblastic components. Choriocarcinomatous differentiation of the gastric carcinoma was suggested to occur during the down growth of the neoplasm. Present gastric choriocarcinoma supports the concept that gastric choriocarcinoma arises from alternate differentiation pathway of adenocarcinoma. Such synchronous occurrence of double carcinomas in the stomach may also suggest a higher oncogenesis stage of the stomach of this woman.
Kojima N, Mori H. Synchronous Occurrence of Carcinoma with Choriocarcinomatous Differentiation and Separated Adenocarcinoma in the Stomach: A Case Report. Clin Case Rep Int. 2020; 4: 1175.