A mass-forming cystic appearance of peritoneal recurrence of gastric adenocarcinoma

• Published in: Journal of cancer research and practice 2018-12, Vol.5 (4), p.169-171
• Main Authors: Kume, Ayako, Yamashita, Hiroharu, Nishida, Masato, Abe, Hiroyuki, Fukayama, Masashi, Seto, Yasuyuki
• Format: Article
• Language: English
• Subjects: Gastric cancer; Hematology, Oncology, and Palliative Medicine; Peritoneal recurrence; Trophoblastic differentiation
• ISSN: 2311-3006; 2311-3006
• DOI: 10.1016/j.jcrpr.2018.06.002

Abstract Metastatic peritoneal tumors of gastric origin usually appear as multiple small nodules on the peritoneal surface or as scirrhous-type infiltrating lesions. A mass-forming cystic appearance is highly unusual and is unique to peritoneal metastasis. Herein, we report a 79-year-old man who presented with a rapidly growing pelvic tumor after total gastrectomy for advanced gastric cancer. Fine needle aspiration yielded a diagnosis of recurrent gastric cancer. Chemotherapy failed to slow the disease progression, and an exophytic tumor in the pelvic cavity caused secondary urethral as well as large bowel obstruction. The tumor, resected by Hartmann’s procedure, consisted of a large quantity of old blood, necrotic tumor tissues and a thick wall surrounding the capsule. A pathological evaluation revealed syncytiotrophoblast cell-like multinucleated giant cells that were positive for the beta subunit of human chorionic gonadotropin, suggesting trophoblastic differentiation of the recurrent tumor. Repeated internal hemorrhage associated with a trophoblastic histological phenotype may have been the cause of the unusually rapid cystic expansion.