ABSTRACT
Primary gastric chorioadenocarcinoma [PGC] is a rare and rapidly invasive tumor. Choriocarcinoma is usually known to be of endometrial origin and gestational; however, it has been reported in other extragenital organs, such as the gall bladder, prostate, lung, liver, and the gastrointestinal tract. Human chorionic gonadotropin related neoplasms of the stomach are seldom discussed in the literature. We report a case of PGC in a 56-year-old man treated with a standard non-gestational choriocarcinoma chemotherapy regimen, EMA/CO [etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine], with a complete response and good tolerability
ABSTRACT
The objective of this study was to evaluate the pattern of relapse and the management experience of metastatic and relapsed breast cancer in Oman. Patients who presented to the Royal Hospital, Muscat, between January 1999 and September 2001 either with metastatic breast cancer at first presentation or who relapsed after initial adjuvant treatment were included. Treatment for relapsed patient was tailored according to the previous adjuvant treatment, disease free period, and pattern of metastatic disease. Patients who presented with metastatic disease at first presentation were treated with anthracycline based chemotherapy and/or hormonal therapy. Fortynine patients were studied. 48 [98%] females [of which 29 were pre-menopausal] and only one male patient [2%]. The mean age was 52.7 years [range 30-80 years]. Thirtyone patients [63%] had relapsed disease, and 18 patients [37%] presented with metastatic disease at first presentation. The most common sites- of metastatic disease were bone [45%], lung [31%], liver [18%], soft tissue [26%], and brain [4%]. Out of the 18 patients who presented with metastases, 13 [72%] had only one site involved and the others [28%] had between 2-4 involved sites. The mean disease-free period for patients who developed relapse was 32.2 months. The mean progression free survival [PFS] for treated relapsed patients [31 patients] was 10.4 months. Nineteen patients of 31 [61%] received chemotherapy, 12 had anthracyclines, and 7 received taxanes: the mean PFS for both groups was 8.3 months and 11.2 months respectively [p = 0.022] Twenty patients out of 31 received hormonal therapy, and 11 patients did not receive any hormonal therapy: the mean PFS were 14 months and 4 months respectively [p = 0.002]. The mean PFS for patients who presented with metastatic disease [18 patients] was 14.4 months, 12/18 [67%] patients received chemotherapy. The mean PFS for patients who presented with only one metastatic site was 15.5 months versus 11.5 months for patients who presented with more man one metastatic site. This study demonstrated that the majority of out patients still presented with advanced stage. Among the studied patients, the most common metastatic site was bones. Relapsed patients treated with taxanes had significantly longer PFS than those who were treated with anthracyclines. Patients who presented with only one metastatic site had longer PFS than patients who presented with more than one site. Better health education and increasing the awareness of breast cancer is needed