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A case of primary gastric choriocarcinoma with multiple liver metastases is described. A 54- year-old man underwent gastrectomy for an advanced cancer. An ulcerofungating tumor with extensive hemorrhagic necrosis was found in the anterior wall of the prepyloric antrum. The histologic examination revealed a biphasic pattern composed of uninucleated cyto or intermediate trophoblasts and syncytiotrophoblasts. A small area of the adenocarcinoma forming glandular structures and poorly differentiated solid sheets was also noted on the superficial portion of the tumor. Immunohistochemical staining for the beta human chorionic gonadotropin (β-hCG) and the human placental lactogen (hPL) showed strong immunoreactivity, particularly in the cytoplasms of the syncytiotrophoblasts and intermediate trophoblasts, respectively. A diagnosis of the choriocarcinoma was made. Multiple hepatic nodules consistent with metastases were noted on the abdominal sonogram. The serum β-hCG level of the patient was significantly increased.


A case of primary gastric choriocarcinoma with multiple liver metastases is described. A 54- year-old man underwent gastrectomy for an advanced cancer. An ulcerofungating tumor with extensive hemorrhagic necrosis was found in the anterior wall of the prepyloric antrum. The histologic examination revealed a biphasic pattern composed of uninucleated cyto or intermediate trophoblasts and syncytiotrophoblasts. A small area of the adenocarcinoma forming glandular structures and poorly differentiated solid sheets was also noted on the superficial portion of the tumor. Immunohistochemical staining for the beta human chorionic gonadotropin (β-hCG) and the human placental lactogen (hPL) showed strong immunoreactivity, particularly in the cytoplasms of the syncytiotrophoblasts and intermediate trophoblasts, respectively. A diagnosis of the choriocarcinoma was made. Multiple hepatic nodules consistent with metastases were noted on the abdominal sonogram. The serum β-hCG level of the patient was significantly increased.