Primary Choriocarcinoma of the Stomach Presenting as Gastric Hemorrhage

We report a case of primary gastric choriocarcinoma with liver metastasis and transverse colon invasion. A 51-year-old man presented with sudden syncope, and a gastroscopic biopsy showed gastric adenocarcinoma with recent bleeding. A palliative subtotal gastrectomy and segmental resection of the transverse colon was done, and formal histopathologic findings proved the tumor to be a choriocarcinoma with poorly differentiated adenocarcinoma. Choriocarcinoma is characterized by biphasic histologic patterns composed of syncytiotrophoblasts, cytotrophoblasts, and positive immunostaining for cytoplasmic hCG, as well as an increased serum hCG levels. This unusual tumor probably resulted from dedifferentiation of a primary adenocarcinoma. Therefore, in the case of a poorly differentiated adenocarcinoma of the stomach, meticulous examination to detect trophoblastic differentiation on tissue sections and evaluation of serum hCG should be made. This tumor is rapidly invasive and resistant to multiple chemotherapies.

Effect of Autologous Peripheral Blood Mononuclear Cell Transplantation on Patients with Chronic Ischemic Limb

PURPOSE: In the present study, the effects of autologous peripheral blood mononuclear cells (PBMNC) transplantation after granulocyte colony stimulation factor (G-CSF)-induced mobilization was investigated in patient with severe peripheral arterial disease. METHOD: 4 cases were enrolled: 3 cases are atherosclerosis obliterance and 1 case is thromboangitis obliterance. Following administration of G-CSF (10microgram/kg, maximum 600microgram), 4 times for 4 days. PBMNC were harvest and injected via femoral artery to vascular foot bed. RESULT: No serious complication was observed during G-CSF injection, harvest and injection. Improvement in the ankle brachial pressure index was seen in all patients at 4 weeks and ischemic ulcer improved in 2 of 3 patients. Using of pain control decreased in all cases and increased blood flow at 99 m-Tc perfusion scan in 2 of 2 patients. CONCLUSION: These favorable outcomes strongly suggest a therapeutic impact of transplantation PBMNC in clinical setting.