Abstract
A 79-year-old woman presented with two adjacent tumors, type 1 and type 2, in the upper stomach, detected by gastroscopy. On preoperative biopsy, the tumors were diagnosed as adenocarcinomas. Abdominal CT detected a 2-cm metastatic lesion in the S5/6 area of the liver. We performed total gastrectomy with D2 lymph node dissection and partial liver resection. Histological examination of the resected specimen revealed the type 2 tumor to be an adenocarcinoma; however, the type 1 tumor was diagnosed as a choriocarcinoma consisting of trophoblast-like tumor cells. Pathological staging was pT3N0M1 (stage IV). Primary gastric choriocarcinoma is a very rare disease, and the prognosis is extremely poor. Most patients with distant metastases reportedly die within 1 year. The disease-free survival in our case was 3 years and 3 months after surgery. The outcome of our case suggests the possibility of long-term survival after simultaneous resection of primary gastric choriocaricinoma and solitary synchronous liver metastasis.
