A Case of Human Chorionic Gonadotropin Producing Gastric Cancer

Hiromitsu Nagata, Naoki Yokoo, Yasuhito Kitakado, Junmay Ryo, Takahiro Yoshida, Koji Kitamura, Tetsuya Shiota and Kiyohisa Okamoto*

Department of Surgery and Department of Pathology*, Takayama Red Cross Hospital

We report a case of human chorionic gonadotropin (HCG) producing gastric cancer with metastases to Virchow's lymph node and a paraaortic lymph node. A 65-year-old woman with cervical tumors was found in an excisional biopsy to have cancer metastasis confirmed based on a histological examination of the specimen. Immunological staining showed that the part with the cancer had cells positive for HCG. Gastrointestinal endoscopy (GIE) and computed tomographic (CT) showed advanced HCG-producing gastric cancer with metastases to Virchow's lymph node and a paraaortic lymph node. Under a diagnosis of advanced HCG-producing gastric cancer with the above metastases, we administered TS-1 as neoadjuvant chemotherapy orally for 2 course. Since down staging was observed after the second course, total gastrectomy, splenectomy, and D2 lymphadenectomy were done. Histological findings confirmed the proposed diagnosis. Virchow's lymph node swelling was observed on postoperative day (POD) 19 and thereafter. Despite repeated chemotherapy with TS-1, the metastatic lesion in the lymph node enlarged rapidly and she died on POD 102.

Key words
gastric cancer, human chorionic gonadotropin, TS-1

Reprint requests
Hiromitsu Nagata Department of Surgery, Takayama Red Cross Hospital
3-11 Tenman-cho, Takayama, 506-8550 JAPAN

Accepted
April 27, 2005

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