A case report of bladder urothelial carcinoma in combination with trophoblast and the literature review / 中华泌尿外科杂志

Objective To investigate the clinical features,therapeutic methods,therapeutic effect and prognosis of a case of bladder urothelial carcinoma patients in combination with trophoblast.Methods The pathological data of a patient with bladder high grade urinary epithelial carcinoma in combination with trophoblast was retrospectively analyzed and the related literatures were reviewed.It was a male patient,69 years old,presenting with total painless gross hematuria.The CT scan showed irregular nodules on the anterior wall of bladder.Results Cystoscopy showed 1.5 cm cauliflower mass on the anterior wall of bladder,and transurethral resection of bladder tumor was performed.The pathology and immunohistochemistry showed urothelial carcinoma.Lung metastases was found due to hemoptysis,and increased serum beta human chorionic gonadotropin (β-HCG) was detected simuhaneously.Pathology was double checked and bladder urothelial carcinoma with trophoblast cell differentiation was considered.Three cycles gemcitabine + cisplatin (GC regimen) and 2 cycles etoposide + methotrexate + vincristine + cyclophosphamide (modified EMA-CO regimen) therapies were given,and the disease was stable at that time.The patient died on June 10,2016,and the total survival period was 9 months.Conclusions The clinical and imaging of urothelial carcinoma with trophoblast differentiation is not special.Diagnosis must depend on the pathological and immunohistochemistry examinations.The efficacy can be evaluated by combining imaging with serumβ-HCG.Treatment should be systemic venous chemotherapy.

Poorly Differentiated Endometrial Adenocarcinoma with Trophoblastic Differentiation / 대한산부인과학회잡지

Trophoblastic differentiation in gynecologic nontrophoblastic tumor is very rare. Here we present a 66-year-old female with poorly differentiated endometrial carcinoma showing trophoblast-like differentiation. This tumor was in advanced stage with metastases to lung, liver, and bone at diagnosis. The multinucleated, syncytiotrophoblast-like cells were positive for beta-human chorionic gonadotropin (beta-hCG) by immunochemical stain. The level of beta-hCG was also elevated (219 mIU/ml) in the patient's serum, but dropped after surgery and chemotherapy. beta-hCG may be used as tumor marker in this case.

Choriocarcinoma of the Colon

Choriocarcinoma of the gastrointestinal tract is rare. Among them, that of the stomach is the most common. Six cases of choriocarcinoma of the colon were found in the review of the literature. All of these previously reported cases had multiple metastatic foci in the liver, lung, lymph nodes and the prognosis seemed to be very poor. Therefore we think that choriocarcinoma of the colon should be distinguished from conventional adenocarcinoma. A 66-year old female patient, described in this case, was operated on under the impression she was suffering from acute appendicitis. The resected ascending colon revealed extensive hemorrhagic necrosis and perforation with fibrous adhesion in the cecum. On the cut section, the mural tumorous thickening was not definite. Histologically, the tumor showed a focus of typical adenocarcinoma arising from glandular epithelial cells, which were transformed into highly anaplastic tumor cells. There were frequent vascular invasions of tumor cells, similar to syncytiotrophoblasts. In the immunohistochemical stains, both glandular and highly anaplastic tumor cells reacted with cytokeratin. The glandular cells were also reactive for carcinoembryonic antigen (CEA) and anaplastic tumor cells for human chorionic gonadotrophin (hCG). This is the first report of choriocarcinoma of the colon in Korea. We describe this case with a review of the literature.