男性胃原发性绒毛膜癌一例并文献复习

Primary gastric choriocarcinoma in male patients: A case report and literature review

目的:探讨男性胃原发性绒毛膜癌的发病因素,诊断、鉴别诊断及治疗方案。方法:对1例男性胃原发性绒毛膜癌病例进行临床表现、病理学特点、免疫组化检测,并进行相关文献复习。结果:镜下显示部分瘤细胞似细胞滋养层细胞和合体滋养层细胞;部分瘤细胞为低分化腺癌细胞。免疫组化示肿瘤细胞CK、CK7表达阳性;合体滋养细胞HCG表达阳性;腺癌细胞EMA、CEA表达阳性。采用手术加化疗的综合治疗,6个月后患者因肺转移,多脏器功能衰竭死亡。结论:发生于男性胃原发性绒毛膜癌极其罕见,恶性程度高,治疗难度大,以综合治疗为主,预后差。

Objective：To investigate the pathogenetic factors,differential diagnosis and treatment regimen for the primary gastric choriocarcinoma in male patients.Methods：Immunohistochemical technique was used to detect the clinical picture and pathological properties in one case of primary gastric chorio-carcinoma,and related literatures were reviewed.Results：Microscopically,the tumor presented with its partial cells analogou to cytotrophoblasts and syncy-tiotrophoblasts,and other cells were low-differentiated adenocarcinoma.Immunohistochemistry findings revealed positive expression of CK and CK7 for the tumor cells,HCG for the syncytiotrophoblasts,and EMA and CEA for the adenocarcinoma.Treatments were associated with surgery and chemotherapy,yet the patient died 6 months later due to lung metastasis and mutiple organs failure .Conclusion：Primary gastric choriocarcionma is a rare case in males with highest malignancy,which makes difficult treatment and poor prognosis,though its therapy regimen currently relies on integrated options.