샘암과 동반된 위의 원발성 융모상피암 1예
A case of primary gastric choriocarcinoma associated with adenocarcinoma
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초록
위의 원발성 융모상피암은 대단히 드물지만 또한 대단히 악성인 종양으로, 저자들은 혈변을 주소로 내원한 58세 남자에서 위절제술로 샘암과 동반된 위의 원발성 융모상피암으로 확진된 1예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.
Abstract
Choriocarcinoma is a HCG-producing epithelial neoplasm derived from either trophoblastic or totipotential germ cells. It is a highly malignant tumor, which is rapidly invasive and widely metastatic, and in most cases develops within the uterus after a normal or abnormal gestation, including ectopic pregnancy. Non-gestational choriocarcinoma rarely occur as a primary neoplasm in the gonads or in the extragonadal midline locations such as mediastinum, retroperitoneum, and pineal gland. It also has been reported very rarely to arise in parenchymal organs such as the prostate, lung, breast, brain, liver, kidney, bladder, vagina, and gastrointestinal tract. A 58-year old man was admitted to our hospital with symptoms of tarry stool and epigastric discomfort. The endoscopic biopsy specimen initially revealed pooly differentiated carcinoma of stomach with regional lymph node metastasis. Patient underwent distal gastrectomy with Billroth II anastomosis. Choriocarcinoma of stomach with well differentiated tubular adenocarcinoma was diagnosed by the surgical biopsy specimen, and the serum level of β-HCG was 2,775 mIU/mL. In three months after operation, the patient presented with pain on right upper quadrant abdomen, and the CT scan revealed multiple liver metastasis. Bleomycin, etoposide, and cisplatin (BEP) combination chemotherapy were administered, but he died three months after the initial diagnosis.
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