Primary gastric choriocarcinoma is a rapidly growing neoplasm with an average survival of several months in untreated patients.Gastrectomy with lymph node dissection followed by chemotherapy is the treatment of choice...Primary gastric choriocarcinoma is a rapidly growing neoplasm with an average survival of several months in untreated patients.Gastrectomy with lymph node dissection followed by chemotherapy is the treatment of choice.Regimens used for gastric adenocarcinoma are usually selected.However,median survival remains less than six months.In this case report,we describe a case of primary gastric choriocarcinoma with a clinical complete response to multidisciplinary treatment including surgery,chemotherapy,and radiofrequency ablation(RFA).The patient was originally referred for general malaise.Esophagogastroduodenoscopy demonstrated a large tumor occupying the fornix,and total gastrectomy with lymph node dissection was performed.Seven days later,multiple liver metastatic recurrences with high serum levels of beta-human chorionic gonadotropin(β-hCG) were recognized.Chemotherapy with a gonadal choriocarcinoma regimen consisting of etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine(EMA/CO),was initiated.After three cycles,serum β-hCG decreased markedly and the tumors disappeared.Six months later,multiple lung metastatic recurrences were found.After one cycle of EMA/CO,only one nodule remained.Computed tomography-guided RFA was performed for this oligometastatic tumor.The patient has been alive with no evidence of disease for 10 years after the initial diagnosis.To the best of our knowledge,this patient with recurrent primary gastric choriocarcinoma has achieved the longest survival.The present case is the first report of choriocarcinoma metastatic to the lung successfully treated with RFA.From our retrospective analysis of recurrent or unresectable primary gastric choriocarcinoma,we propose that gonadal choriocarcinoma regimens can be considered as first-line for primary gastric choriocarcinoma.展开更多
We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course.The patient was a 49-year-old man who presented with acute right-sided abdominal pain.There were no mass...We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course.The patient was a 49-year-old man who presented with acute right-sided abdominal pain.There were no masses palpable on physical examination.Radiographic findings showed large multi-nodular tumors mainly in the right lobe of the liver.Fludeoxyglucosepositron emission tomography scan showed uptake only in the liver,and no uptake in the testes.We initially planned to perform a liver resection for the presumed diagnosis of intra-hepatic cholangiocarcinoma.However,the tumors grew rapidly and ruptured.Multiple lung metastases rapidly developed resulting in respiratory failure,preventing liver resection or even biopsy.He died 60 d after initial presentation with no pathological diagnosis.Postmortem studies included histopathological and immunohistological examinations which diagnosed a primary choriocarcinoma of the liver.Primary hepatic choriocarcinoma is very rare but should be considered in the differential diagnosis of a liver tumor in a middle aged man.Establishing this diagnosis may enable treatment of the choriocarcinoma.Liver biopsy and evaluation of serum human chorionic gonadotropin are recommended in these patients.展开更多
Background: Choriocarcinoma is a rare clinical condition, and its diagnosis may be difficult, especially in resource-limited settings. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intract...Background: Choriocarcinoma is a rare clinical condition, and its diagnosis may be difficult, especially in resource-limited settings. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intractable vaginal bleeding and offensive vaginal discharge, but without antecedent pregnancy. She had previously been managed at various tertiary medical institutions where several pelvic ultrasound scans and even histology of endometrial curette could not clinch the diagnosis. The diagnosis of choriocarcinoma was made by a serial strip-based pregnancy testing, which was still positive at 1:200 dilutions. She was treated with chemotherapy involving Adriamycin, Cyclophosphamide, Methotrexate and Folinic acid. Conclusion: The diagnosis of choriocarcinoma may be difficult especially when it develops ab initio without preceding abortion, molar or term pregnancy. In settings where serum hCG assay may be not available, the simple strip-based pregnancy test in dilution could be helpful in its diagnosis and treatment monitoring.展开更多
From the published data, the present mini-review attempts to answer two fundamental questions about the gestational trophoblastic neoplasms. In addition, it extrapolates the findings to other cancers that produce smal...From the published data, the present mini-review attempts to answer two fundamental questions about the gestational trophoblastic neoplasms. In addition, it extrapolates the findings to other cancers that produce small amounts of hCG and how a novel therapies could be developed.展开更多
目的研究Fas/FasL在绒毛膜癌细胞中的表达,及绒癌细胞与Jurkat细胞共培养诱导T细胞凋亡的机制。方法用免疫荧光染色法检测绒癌细胞系Fas/FasL的阳性表达情况,MTT法检测随时间变化绒癌细胞对Jur-kat细胞的抑制情况,流式细胞仪检测Jurkat...目的研究Fas/FasL在绒毛膜癌细胞中的表达,及绒癌细胞与Jurkat细胞共培养诱导T细胞凋亡的机制。方法用免疫荧光染色法检测绒癌细胞系Fas/FasL的阳性表达情况,MTT法检测随时间变化绒癌细胞对Jur-kat细胞的抑制情况,流式细胞仪检测Jurkat细胞与绒癌细胞共培养24 h、中和抗体NOK-2封闭FasL24 h Jurkat细胞的凋亡情况,透射电镜观察细胞的凋亡形态。结果绒癌细胞上均有Fas及FasL的表达,在绒癌细胞上Fas的阳性表达较低,而FasL表达较多(P<0.05)。绒癌细胞与Jurkat细胞共培养可诱导Jurkat细胞凋亡,绒癌细胞与Jurkat细胞共培养后随着时间的延长Jurkat细胞的凋亡率增加(P<0.05),出现特征性凋亡形态特征。用中和抗体NOK-2封闭细胞表面FasL后,Jurkat细胞的凋亡率下降。结论两种绒癌细胞上均有Fas及Fasl的表达,绒癌细胞能抵抗Fas介导的凋亡,其表面的FasL可抑制T细胞的免疫功能,Fas/FasL途径是绒癌细胞免疫逃逸的重要机制之一。展开更多
文摘Primary gastric choriocarcinoma is a rapidly growing neoplasm with an average survival of several months in untreated patients.Gastrectomy with lymph node dissection followed by chemotherapy is the treatment of choice.Regimens used for gastric adenocarcinoma are usually selected.However,median survival remains less than six months.In this case report,we describe a case of primary gastric choriocarcinoma with a clinical complete response to multidisciplinary treatment including surgery,chemotherapy,and radiofrequency ablation(RFA).The patient was originally referred for general malaise.Esophagogastroduodenoscopy demonstrated a large tumor occupying the fornix,and total gastrectomy with lymph node dissection was performed.Seven days later,multiple liver metastatic recurrences with high serum levels of beta-human chorionic gonadotropin(β-hCG) were recognized.Chemotherapy with a gonadal choriocarcinoma regimen consisting of etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine(EMA/CO),was initiated.After three cycles,serum β-hCG decreased markedly and the tumors disappeared.Six months later,multiple lung metastatic recurrences were found.After one cycle of EMA/CO,only one nodule remained.Computed tomography-guided RFA was performed for this oligometastatic tumor.The patient has been alive with no evidence of disease for 10 years after the initial diagnosis.To the best of our knowledge,this patient with recurrent primary gastric choriocarcinoma has achieved the longest survival.The present case is the first report of choriocarcinoma metastatic to the lung successfully treated with RFA.From our retrospective analysis of recurrent or unresectable primary gastric choriocarcinoma,we propose that gonadal choriocarcinoma regimens can be considered as first-line for primary gastric choriocarcinoma.
基金Supported by Clinical Research Support Team of Jichi Medial University
文摘We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course.The patient was a 49-year-old man who presented with acute right-sided abdominal pain.There were no masses palpable on physical examination.Radiographic findings showed large multi-nodular tumors mainly in the right lobe of the liver.Fludeoxyglucosepositron emission tomography scan showed uptake only in the liver,and no uptake in the testes.We initially planned to perform a liver resection for the presumed diagnosis of intra-hepatic cholangiocarcinoma.However,the tumors grew rapidly and ruptured.Multiple lung metastases rapidly developed resulting in respiratory failure,preventing liver resection or even biopsy.He died 60 d after initial presentation with no pathological diagnosis.Postmortem studies included histopathological and immunohistological examinations which diagnosed a primary choriocarcinoma of the liver.Primary hepatic choriocarcinoma is very rare but should be considered in the differential diagnosis of a liver tumor in a middle aged man.Establishing this diagnosis may enable treatment of the choriocarcinoma.Liver biopsy and evaluation of serum human chorionic gonadotropin are recommended in these patients.
文摘Background: Choriocarcinoma is a rare clinical condition, and its diagnosis may be difficult, especially in resource-limited settings. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intractable vaginal bleeding and offensive vaginal discharge, but without antecedent pregnancy. She had previously been managed at various tertiary medical institutions where several pelvic ultrasound scans and even histology of endometrial curette could not clinch the diagnosis. The diagnosis of choriocarcinoma was made by a serial strip-based pregnancy testing, which was still positive at 1:200 dilutions. She was treated with chemotherapy involving Adriamycin, Cyclophosphamide, Methotrexate and Folinic acid. Conclusion: The diagnosis of choriocarcinoma may be difficult especially when it develops ab initio without preceding abortion, molar or term pregnancy. In settings where serum hCG assay may be not available, the simple strip-based pregnancy test in dilution could be helpful in its diagnosis and treatment monitoring.
文摘From the published data, the present mini-review attempts to answer two fundamental questions about the gestational trophoblastic neoplasms. In addition, it extrapolates the findings to other cancers that produce small amounts of hCG and how a novel therapies could be developed.
文摘目的研究Fas/FasL在绒毛膜癌细胞中的表达,及绒癌细胞与Jurkat细胞共培养诱导T细胞凋亡的机制。方法用免疫荧光染色法检测绒癌细胞系Fas/FasL的阳性表达情况,MTT法检测随时间变化绒癌细胞对Jur-kat细胞的抑制情况,流式细胞仪检测Jurkat细胞与绒癌细胞共培养24 h、中和抗体NOK-2封闭FasL24 h Jurkat细胞的凋亡情况,透射电镜观察细胞的凋亡形态。结果绒癌细胞上均有Fas及FasL的表达,在绒癌细胞上Fas的阳性表达较低,而FasL表达较多(P<0.05)。绒癌细胞与Jurkat细胞共培养可诱导Jurkat细胞凋亡,绒癌细胞与Jurkat细胞共培养后随着时间的延长Jurkat细胞的凋亡率增加(P<0.05),出现特征性凋亡形态特征。用中和抗体NOK-2封闭细胞表面FasL后,Jurkat细胞的凋亡率下降。结论两种绒癌细胞上均有Fas及Fasl的表达,绒癌细胞能抵抗Fas介导的凋亡,其表面的FasL可抑制T细胞的免疫功能,Fas/FasL途径是绒癌细胞免疫逃逸的重要机制之一。
