Abstract
A 69-year-old man visited the hospital because of tarry stool. On image inspection, rectal cancer and multiple liver and lung metastases were observed. Disseminative lesions were observed in the abdominal cavity. There was no bleeding from the rectal cancer and no hemorrhagic change based on upper gastrointestinal endoscopy. We decided to operate because bleeding control by conservative therapy was impossible. Three disseminative lesions accompanied by intraperitoneal bleeding were observed in the small intestine. Partial excisions of each lesion were carried out, and high anterior resection was enforced to rectal cancer. Upon histopathological examination, multinucleated giant cells such as syncytiotrophoblasts were scattered throughout the specimen, whereas the small intestines exhibited HCG positivity on immunohistochemical staining, and choriocarcinoma was diagnosed. Four days after the operation, gastrointestinal bleeding and aggravation of liver function were again detected, and all of the metastases, including that of the liver, quickly worsened. The patient died 18 days after the operation.
