Coexistence of Choriocarcinoma and Hepatoid Adenocarcinoma in Early Gastric Cancer

We report here the first case of early gastric carcinoma showing the histological features of choriocarcinoma and hepatoid adenocarcinoma. A 68-year-old woman was admitted to our hospital for treatment of gastric cancer detected by her primary care physician. X-ray examination of the stomach and esophagogastroduodenoscopy revealed a 0-I type, 25 × 20mm tumor occupying the greater wall of the upper gastric body. The biopsy specimens obtained from the tumor revealed a poorly differentiated adenocarcinoma, and a total gastrectomy with lymph node dissection was carried out. Macroscopically, there was a protruding lesion (0-I type) measuring 25 × 20mm in size in the upper third of the greater curvature of the stomach. Microscopically, features of choriocarcinoma and hepatoid adenocarcinoma were present in the tumor. Immunohistochemically, the choriocarcinoma component was positive for the β-subunit of human chorionic gonadotropin and human placental lactogen. The hepatoid carcinoma component was positive for α-fetoprotein. To the best of our knowledge, there is only one similar case report of advanced gastric cancer, the our present patient is the first case of early gastric carcinoma showing the coexistence of choriocarcinoma and hepatoid carcinoma. This patient is still alive 19 months after surgery, without recurrence