A Case of the Gastric Carcinoma with High Serum Human Chorionic Gonadotropin and Alpha-Fetoprotein Level -Differentiation to Germ Cell Tumor-

Michio Maruyama, Toshifumi Kudo, Hiroshi Kuwabara, Susumu Takamatsu, Norihide Sugano, Masakazu Ebuchi

Department of Surgery, Tokyo Metropolitan Ohkubo Hospital

This is a case of gastric cancer in a 49-year-old woman who had a huge tumor with an extragastric extension and showed high levels of serum HCG (17,000 mlU/ml) and AFP (489 n/ml). The resected specimen revealed that this tumor consisted of 3 histological components, poorly differentiated adenocarcinoma (CEA positive), a choriocarcinoma-like lesion (HCG positive) and a yolk sac tumor-like compoment (AFP positive). Thought the operation was curative, the patient died of recurrence of the carcinoma on the 45th day after the operation. This is the first reported gastric cancer case with the histological combination of choriocarcinoma and yolk sac tumor leions which caused the high levels of serum HCG and AFP. The author speculated on the possibility of retrodifferentiation of neoplastic mucosal epithelial cells in regard to the coexistence of a choriocarcinoma-like and a yolk sac tumor-like lesions. This case represented simultaneous differentiation along 2 lines of the extra-embryonic elements.

Key words
choriocarcinoma of the stomach, yolk sac tumor of the stomach, human chorionic gonadotropin and alphafetoprotein producing gastric cancer

Reprint requests
Michio Maruyama Department of Surgery, Tokyo Metropolitan Ohkubo Hospital
2-44-1 Kabuki-cho, Shinju-ku, Tokyo, 160 JAPAN

Accepted
June 11, 1997

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