الملخص
El coriocarcinoma gástrico primario (CGP) es un tumor extremadamente raro, altamente invasivo y de rápida diseminación hematógena. Presentamos el caso de una paciente de 57 años que inicia con cuadro de hematemesis y, progresivamente, se le suman episodios de melena, baja de peso y epigastralgia. Es derivada al Instituto Nacional de Enfermedades Neoplásicas en donde se le realizan gastroscopía y biopsia. Así, el análisis histológico reportó patrón sugestivo para CGP; el cual se confirmó al realizarle a la paciente los estudios por imágenes necesarios y llevar a cabo el análisis inmunohistoquímico para gonadotrofina coriónica humana y alfa feto proteína. Posteriormente, a la paciente se le realiza una gastrectomía radical D2 con preservación esplénica y de cola de páncreas. Lamentablemente, su evolución no fue favorable y fallece por la progresión de la enfermedad.
Primary gastric choriocarcinoma (PGC) is an extremely rare and highly invasive tumor with rapid hematogenous spread. We present the case of a 57-year-old female patient who started with hematemesis and progressive episodes of melena, weight loss and epigastralgia. It is derived from the National Institute of Neoplastic Diseases where gastroscopy and biopsy are performed. Histological analysis reported pattern suggestive of PGC; that was confirmed by immunohistochemical analysis for human chorionic gonadotrophin and fetal alpha protein. Subsequently, the patient underwent a radical D2 gastrectomy with splenic preservation and tail of the pancreas preservation. Unfortunately, her evolution was not favorable and died due to the progression of the disease.
الموضوعات
Female , Humans , Middle Aged , Stomach Neoplasms/pathology , Choriocarcinoma/pathology , Polyps/diagnosis , Polyps/pathology , Stomach Neoplasms/surgery , Stomach Neoplasms/diagnosis , Stomach Neoplasms/chemistry , Stomach Ulcer/etiology , Weight Loss , Adenocarcinoma/diagnosis , alpha-Fetoproteins/analysis , Choriocarcinoma/surgery , Choriocarcinoma/diagnosis , Choriocarcinoma/chemistry , Biomarkers, Tumor/analysis , Hematemesis/etiology , Melena/etiology , Gastroscopy , Fatal Outcome , Diagnosis, Differential , Gastrectomy/methods , Chorionic Gonadotropin/analysisالملخص
Skin metastasis of testicular choriocarcinoma is very rare. Until now about nine cases have been reported in the English literature; however, only one of them has been diagnosed by fine-needle aspiration (FNA) cytology. Herein, we report our experience with FNA cytology diagnosis of a metastatic testicular choriocarcinoma to the skin of chin. The combination of highly atypical mononuclear cells (cytotrophoblasts) and multinucleated malignant cells (syncytiotrophoblasts) are characteristic of metastatic tumor in a known case of choriocarcinoma of testis.
الموضوعات
Adult , Biopsy, Fine-Needle , Choriocarcinoma/diagnosis , Choriocarcinoma/pathology , Choriocarcinoma/secondary , Cytological Techniques , Humans , Male , Microscopy , Neoplasm Metastasis/diagnosis , Neoplasm Metastasis/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/secondary , Testicular Neoplasms/diagnosis , Testicular Neoplasms/pathology , Testicular Neoplasms/secondaryالملخص
O presente relato descreve um caso de carcinoma mamário em paciente de 45 anos, com diferenciação coriocarcinomatosa, caracterizado por presença de células bizarras, anaplásicas, com áreas de necrose e células gigantes multinucleadas, com imunopositividade para a subunidade β da gonadotrofina coriônica humana (β-HCG) e cromogranina, medindo 5,7 cm no maior eixo, refratário ao tratamento neoadjuvante inicial. Realizada mastectomia, cujo diagnóstico após análises microscópica e imuno-histoquímica concluiu tratar-se de carcinoma com características coriocarcinomatosas. Tais lesões são raras, capazes de sintetizar substâncias hormonais não próprias ao tecido mamário, sendo o diagnóstico de grande importância para a abordagem terapêutica e prognóstica, pois constituem um grupo de lesões potencialmente agressivas.
This report describes the case of a 45 year-old patient with breast carcinoma characterized by choriocarcinomatous features, presence of bizarre anaplastic cells with areas of necrosis and multinucleated giant cells. The immuno-histochemical analysis showed positivity for chromogranin and β-HCG. The tumor size was 5.7 cm at the largest axis and it was refractory to initial neo-adjuvant treatment. Mastectomy was performed and after microscopic and immuno-histochemical examination it was diagnosed as carcinoma with choriocarcinomatous features. These lesions are rare and liable to synthesize hormonal substances not specific to breast tissue. Its diagnosis is highly significant to the therapeutic and prognostic approach insofar as these lesions are potentially aggressive.
الموضوعات
Humans , Female , Middle Aged , Choriocarcinoma/pathology , Breast Neoplasms/diagnosis , Breast Neoplasms/pathologyالملخص
Primary choriocarcinoma of the uterine cervix is a rare disease. The accurate diagnosis of such a disease is difficult to achieve because of its rarity. Furthermore, the majority of cases presented with abnormal vaginal bleeding that could be caused by other more common conditions including, threatened abortion, cervical polyp, cervical pregnancy, or cervical cancer. In the present report, the authors present a case of large cervical choriocarcinoma with life-threatening vaginal bleeding, which was initially misdiagnosed as a cervical cancer The active cervical bleeding was successfully controlled with selective uterine arterial embolization. Remission of cervical choriocarcinoma was accomplished with combination chemotherapy without the need of hysterectomy.
الموضوعات
Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Choriocarcinoma/pathology , Cytarabine/administration & dosage , Diagnosis, Differential , Embolization, Therapeutic , Etoposide/administration & dosage , Female , Humans , Mitoxantrone/administration & dosage , Pregnancy , Pregnancy Complications, Neoplastic/pathology , Ultrasonography, Doppler, Color , Uterine Neoplasms/pathologyالملخص
Choriocarcinoma is a rare malignant genital tract tumor, arising in the uterus or in the testis. These tumors in women usually follows a pregnancy. It is more common after a molar pregnancy. A 35 years old married woman was admitted with two weeks history of bleeding per rectum. Patient was explored via a midline incision. A 2x2 cm polypoidal lesion was found in terminal ileum and a haemorrhagic cystic mass seen in upper pole of right kidney. Uterus was bulky. Heal lesion was resected and anastomosis done. Excision Biopsy was taken from the renal mass, conserving the kidney. Resected Heal tissue and kidney mass were reported as Choriocarcinoma
الموضوعات
Humans , Female , Adult , Choriocarcinoma/pathology , Biopsyالملخص
The present case demonstrates how a clinico-pathological approach of a forensic pathologist played a key role in deciding a sudden suspicious death and also highlights the characteristics of gestational choriocarcinoma and its importance’s in post mortem diagnosis among the forensic experts and clinicians. Investigating authorities were curious in knowing whether the death was due to criminal abortion or suicidal consumption of poisoning. The case was unraveled so that the rested soul is given justice and free from all defames.
الموضوعات
Adolescent , Autopsy , Choriocarcinoma/diagnosis , Choriocarcinoma/pathology , Death, Sudden , Female , Forensic Pathology , Gestational Trophoblastic Disease/diagnosis , Gestational Trophoblastic Disease/pathology , Humans , India , Neoplasm Metastasisالملخص
La ETG es el término general utilizado para identificar distintos procesos donde existe una hiperplasia de diferentes tipos de epitelio trofoblástico, según la OMS puede clasificarse en 4 tipos: 1) Mola hidatiforme: completa o parcial, más común la primera en un 67 por ciento, 2) Mola invasora (corioadenoma destruens) 3) Coricarcinoma 4)Tumor trofoblástico del lecho placentario, su incidencia varia, pero en países desarrollados se estima sea 1.1/1000 embarazos, siendo esta mas alta en países subdesarrollados se presenta caso clìnico de una paciente la cual se le hace diagnóstico clínico e histopatológico y procedimientos para evacuación uterina por embarazo molar.
الموضوعات
Humans , Adult , Female , Pregnancy , Gestational Trophoblastic Disease/diagnosis , Gestational Trophoblastic Disease/pathology , Trophoblastic Tumor, Placental Site/pathology , Uterus/anatomy & histology , Choriocarcinoma/pathology , Hydatidiform Mole, Invasive/diagnosis , Hydatidiform Mole, Invasive/pathologyالملخص
La enfermedad trofoblástica gestacional constituye un grupo de enfermedades propias de la gestación que pueden ser benignas o malignas, caracterizadas por proliferación anormal de las células sinciciales y de Langhans del trofoblasto, que interfieren con el desarrollo embrionario. Clínicamente se presenta como un embarazo normal, ya que hay amenorrea, sialorrea y vómitos, pero existe sangrado, crecimiento uterino no acorde con la edad gestacional, expulsión de vesículas a través de los genitales, útero hipotónico, no se palpan partes fetales, movimientos ni latidos cardíacos. Trabajo tipo descriptivo con medición independiente de variables; retrospectivo, documental, población y muestra de 8 casos luego de revisar las historias clínicas de este centro de salud. 50 por ciento estaban entre 21 a 26 años. El antecedente Ginecoobstétrico predominante fue la multiparidad con 54,5 por ciento, seguido de cesáreas y abortos con 18,18 por ciento respectivamente. El 37,5 por ciento tuvo entre 14 y 18 semanas de gestación, similar porcentaje para las que ignoraban la fecha de última regla. El método quirúrgico más empleado fue el legrado por aspiración con 37,5 porciento. Diagnosticándose finalmente 37 por ciento de mola invasora con un caso de metástasis a pulmón a los 4 años. Es importante destacar que 25 por ciento de las pacientes con diagnóstico clínico y ecográfico no se les practicó biopsia. Se presenta en mujeres en edad fertil, multíparas, durante el primer trimestre de embarazo, se recomienda practicar biopsias a todo material producto de abortos y embarazos anembrionarios.
الموضوعات
Humans , Adult , Female , Pregnancy , Middle Aged , Choriocarcinoma/pathology , Embryonic Development/physiology , Vacuum Curettage/methods , Gestational Trophoblastic Disease/diagnosis , Gestational Trophoblastic Disease/pathology , Biopsy/methods , Choriocarcinoma/surgery , Hydatidiform Mole/etiology , Hydatidiform Mole/pathologyالملخص
Pure choriocarcinoma is very rare in the testes, and host immune responses including tumor infiltrating lymphocytes are unusual in choriocarcinoma. This study reports a case of pure testicular choriocarcinoma with extensive lymphocytic infiltrate and granulomatous inflammation. Scrotal ultrasonography revealed a heterogeneous, hyperechoic intratesticular mass. -human chorionic gonadotropin levels were elevated in a radioimmunoassay. The hemorrhagic and necrotic solid mass was composed of two cell populations - mononuclear pleomorphic cells and intimately admixed multinucleated smudged cells. The tumor cells were positive for cytokeratin 7, epidermal growth factor receptors, human placental lactogen and p57. Many inflammatory cells were present within the tumor. The majority of infiltrating cells were CD8-positive cytotoxic cells, which also expressed granzyme-B and TIA-1. The tumor cells were positive for FasL, but negative for Fas. Therefore, this case seemed to escape the host defense response to the tumor due to the loss of Fas, although the cellular host immune response was still active.
الموضوعات
Male , Humans , Adult , Biomarkers, Tumor/analysis , Testicular Neoplasms/pathology , Lymphocytes, Tumor-Infiltrating/pathology , Granuloma/pathology , Chorionic Gonadotropin, beta Subunit, Human/metabolism , Choriocarcinoma/pathologyالملخص
Pure choriocarcinoma is very rare in the testes, and host immune responses including tumor infiltrating lymphocytes are unusual in choriocarcinoma. This study reports a case of pure testicular choriocarcinoma with extensive lymphocytic infiltrate and granulomatous inflammation. Scrotal ultrasonography revealed a heterogeneous, hyperechoic intratesticular mass. -human chorionic gonadotropin levels were elevated in a radioimmunoassay. The hemorrhagic and necrotic solid mass was composed of two cell populations - mononuclear pleomorphic cells and intimately admixed multinucleated smudged cells. The tumor cells were positive for cytokeratin 7, epidermal growth factor receptors, human placental lactogen and p57. Many inflammatory cells were present within the tumor. The majority of infiltrating cells were CD8-positive cytotoxic cells, which also expressed granzyme-B and TIA-1. The tumor cells were positive for FasL, but negative for Fas. Therefore, this case seemed to escape the host defense response to the tumor due to the loss of Fas, although the cellular host immune response was still active.
الموضوعات
Male , Humans , Adult , Biomarkers, Tumor/analysis , Testicular Neoplasms/pathology , Lymphocytes, Tumor-Infiltrating/pathology , Granuloma/pathology , Chorionic Gonadotropin, beta Subunit, Human/metabolism , Choriocarcinoma/pathologyالملخص
Primary choriocarcinoma of the ovary (PCO) is rare. This can be gestational (GCO) or non-gestational (NGCO) in origin. It is difficult to differentiate between CGO and NGCO. Non-gestational choriocarcinoma carries a bad prognosis than GCO. We present a case of NGCO who had pulmonary metastasis.
الموضوعات
Adolescent , Choriocarcinoma/pathology , Fatal Outcome , Female , Gestational Age , Humans , Ovarian Neoplasms/pathology , Ovary/pathologyالملخص
A 45 year old patient wad admitted with pain abdomen and a palpable mass in the epigastrium of 3 months duration. Endoscopy revealed growth in the stomach and biopsy showed poorly differentiated Carcinoma. Distal radical subtotal gastrectomy was done. Histopathology revealed choriacarcinoma with Syncytiotrophoblastic and cytotrophoblastic and foci of adenocarcinoma. Postoperatively urine and serum had very high levels of beta-human chorionic gonogotrophins (B-HCG). Immunochemistry showed positivity for B-HCG. Clinically and on scan both the testis were normal. Because of its rarity, we are presenting this case with brief review of literature.
الموضوعات
Adult , Choriocarcinoma/pathology , Chorionic Gonadotropin/blood , Humans , Male , Stomach Neoplasms/pathologyالملخص
Los tumores quísticos del páncreas son raros y constituyen sólo 10 a 15 por ciento de las lesiones quísticas del páncreas y 1 por ciento de las neoplasias malignas. Pueden ser benignas o malignos y generalmente son circunscritos y bien localizados. Su identificación, el diagnóstico diferencial y el tratamiento son difíciles y un ejemplo de ello es que hasta una tercera parte pueden confundirse con seudoquistes del páncreas. Los más importantes son los cistadenomas microquísticos serosos, los cistadenomas mucinosos, los cistadenocarcinomas mucinosos, los adenocarcinomas productos de mucina y los adenocarcinomas asociados a seudoquiste o a quiste simple. Los estudios de mayor utilidad para el diagnóstico son el ultrasonido, la tomografía axial computada, la colangiopancreatografía retrógrada endoscópica, la punción guiada del quiste con estudio del líquido y la biopsia. La elección del tipo de tratamiento depende de la variedad del tumor de que trate, de su localización y extensión, del riesgo quirúrgico, de la experiencia del cirujano y de los recursos institucionales. En general, el pronóstico de estos tumores es más favorable que el del adenocarcinoma ductal, aun cuando sean malignos
الموضوعات
Humans , Choriocarcinoma/pathology , Cystadenocarcinoma/pathology , Cystadenoma, Mucinous/pathology , Cystadenoma, Mucinous/surgery , Cystadenoma, Serous , Cystadenoma, Serous/physiopathology , Cystadenoma, Serous/surgery , Pancreatic Neoplasms/pathology , Pancreatic Cyst/pathologyالملخص
Se presenta un caso de hemorragia intestinal como manifestación inicial de un coriocarcinoma testicular. El diagnóstico de la causa de hemorragia requirió laparatomfa. Lesión metastástica del intestino delgado debe considerarse como causa de hemorragia en paciente con coriocarcinoma testicular.
الموضوعات
Humans , Male , Adult , Choriocarcinoma/complications , Gastrointestinal Hemorrhage/etiology , Testicular Neoplasms/complications , Acute Disease , Choriocarcinoma/pathology , Gastrointestinal Hemorrhage/diagnosis , Intestinal Neoplasms/secondary , Intestine, Small/pathology , Testicular Neoplasms/pathologyالملخص
El cariocarcinoma del ovario originado en las células germinales es una neoplasia maligna extraordinariamente rara. En su forma pura se han comunicado muy pocos casos en la literatura médica. El coriocarcinoma ovárico puede originarse bajo tres modalidades diferentes: 1) Como un cariocarcinoma primario asociado a un embarazo ovárico. 2) Como un coriocarcinoma ovárico metastásico de otros órganos, principalmente del útero. 3) Como un tumor primario de células germinales con diferenciación hacia estructuras trofoblásticas. Este último se desarrolla en las niñas o en la mujer adulta, generalmente joven, en donde necesariamente tiene que excluirse el embarazo. Se presenta el caso de una mujer de 21 años, tratada en el Hospital General "Dr. Miguel Silva", SSA de Morelia, Mich. soltera, sin vida sexual, con una tumoración abdomino-pélvica de 24 cm., proveniente del ovario derecho y adherida al colon ascendente. La subunidad beta de gonadotropina coriónica era de 200,000 mUI/ml. de plasma sanguíneo. En la laparotomía se encontró una tumoración del ovario derecho, con infiltración al colon ascendente, que requirió histerectomía total con salpingooferectomía bilateral y hemicolectomía derecha. Después de la cirugía la paciente recibió quimioterapia a base de cisplatino, bleomicina y vinblastina. Después del tercer ciclo de tratamiento y a los 3 meses de operada, la gonadotropina coriónica se negativizó y a los 4 años de seguimiento, no se ha demostrado actividad tumoral residual. La mortalidad mayor en estos tumores se presenta en el postoperatorio temprano y es atribuida al tumor mismo o a las complicaciones postoperatorias. Si la paciente sobrepasa esta etapa y se instala un eficaz esquema quimioterápico, la sobrevida y aún la curación coronan los esfuerzos terapéuticos
الموضوعات
Adult , Humans , Female , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Choriocarcinoma/pathology , Choriocarcinoma/surgery , Chorionic Gonadotropin/blood , Colectomy , Colonic Neoplasms/pathology , Colonic Neoplasms/secondary , Colonic Neoplasms/surgery , Hysterectomy , Neoplasm Invasiveness , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgeryالملخص
A 32-year old Thai woman, gravida 1, para 1, had low risk gestational trophoblastic disease. Evacuation and chemotherapy was given (January 1990). She presented two years later (June 1992) with bilateral cervical lymphadenopathy. Cervical tuberculous lymphadenitis was confirmed by biopsy and Ziehl-Neelsen method. There were no clinical symptoms of tuberculosis. Antituberculous drugs, 2HRZ/4HR (H = isoniazid, R = rifampicin, Z = pyrazinamide) were given and no relapse of either choriocarcinoma or tuberculous lymphadenitis mimicking other pathologic processes and clinical suspicion is warranted.
الموضوعات
Adult , Biopsy , Choriocarcinoma/pathology , Diagnosis, Differential , Female , Humans , Neck , Tuberculosis, Lymph Node/pathology , Uterine Neoplasms/pathologyالملخص
Se estudiaron 5 pacientes con el diagnostico histologico de coriocarcinoma, tomados de solicitudes de biopsias y autopsias en el periodo de 1976 a 1991 en los Departamentos de Anatomia Patologica de los Hospitales Provinciales Docentes Clinicoquirurgico y Ginecobstetrico "Mariana Grajales", de Santa Clara. Se analiza la frecuencia y manifestaciones clinicas, asi como criterio de malignidad y supervivencia relacionados con el patron de formacion de isla. Se utiliza la clasificacion de coriocarcinoma uterino de Nishikawa y su relacion con la clasificacion cirrotica progresiva venosa (CPV) y la de Elston
الموضوعات
Humans , Female , Adolescent , Adult , Choriocarcinoma/classification , Choriocarcinoma/pathology , Uterine Neoplasms/pathologyالملخص
Se presentó un caso de coriocarcinoma ovárico en una mujer de 24 años de edad sin antecedentes de gestaciones. Clínicamente la enfermedad debutó con un cuadro respiratorio y radilógico con características de tuberculosis pulmonar. Por la presencia de una masa tumoral del anexo derecho la paciente fue operada encontrándose un tumor de ovario diagnosticado histológicamente como coriocarcinoma, con implantes neoplásicos en mesosalpinx y pared del cuello uterino. La paciente recibió tratamiento quimioterápico y sobrevivió cuatro años. Se discute la posibilidad de que la neoplasia haya sido primaria o metastásica a ovario