A Resected Case of Primary Gastric Choriocarcinoma with Simultaneous Liver Metastasis

Abstract

An 80-year-old woman presented to our hospital with a chief complaint of loss of appetite and upper abdominal pain. Abdominal computed tomography demonstrated a 15-cm tumor in the lateral segment of the liver, which was enhanced in the early vascular phase and washed out in the late vascular phase. Upper gastrointestinal endoscopy showed a type 3 tumor in the pyloric antrum, which was diagnosed as tubular adenocarcinoma on biopsy. The preoperative diagnosis was gastric carcinoma and hepatocellular carcinoma. Distal gastrectomy was performed, followed by left lateral segmentectomy of the liver after a month. Final histopathological examination showed gastric choriocarcinoma and synchronous liver metastasis. Although adjuvant chemotherapy with S-1 was started after the liver surgery, lung metastasis appeared 12 months later. She has been treated with sequential chemotherapy, and is still alive with recurrence 32 months after surgery.

The prognosis of patients with simultaneous liver metastasis of primary gastric choriocarcinoma (PGC) is extremely poor. However, we expected an improvement in prognosis by curative resection followed by chemotherapy, similar to that for common-type gastric cancer.