Yokoi Kimiyoshi, Tanaka Noritake, Furukawa Kiyonori, Ishikawa Noriyuki, Seya Tomoko, Horiba Koji, Kanazawa Yoshikazu, Yamada Takeshi, Ohaki Yoshiharu, Tajiri Takashi
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Japan.
J Nippon Med Sch. 2008 Apr;75(2):116-21. doi: 10.1272/jnms.75.116.
We report on a patient with male choriocarcinoma. The patient was a 31-year-old male patient with jejunal choriocarcinoma that metastasized from the mediastinum. He was admitted complaining of melena and severe anemia. Upper and lower gastrointestinal endosocopy was performed, but no source of bleeding was seen. Chest X-ray and CT revealed a mediastinal tumor 7 cm in size anterior to the arotic arch. Superior mesenteric arteriography showed irregularities and macular opacity in the jejunal artery. An emergency laparatomy was performed because of massive gastrointestinal bleeding. A jejunal tumor approximately 4 cm in size was resected and numerous metastases were observed in the liver and mesentery. Histopathological examination showed metastatic jejunal choriocarcinoma. Gynecomastia was not present and the testes were normal. Serum beta-human chorionic gonadotropin (HCG) was at an abnormally high level of 4,396 ng/mL. Because of metastases to the brain and invasion to the trachea, he died on postoperative day 20. We report this rare case of a male patient with metastases of choriocarcinoma to the gastrointestinal tract from the mediastinum, together with a review of the literature.
我们报告一例男性绒毛膜癌患者。该患者为一名31岁男性，患有从纵隔转移而来的空肠绒毛膜癌。他因黑便和严重贫血入院。进行了上、下消化道内镜检查，但未发现出血源。胸部X线和CT显示主动脉弓前方有一个7厘米大小的纵隔肿瘤。肠系膜上动脉造影显示空肠动脉不规则且有斑片状模糊影。由于大量胃肠道出血，进行了急诊剖腹手术。切除了一个约4厘米大小的空肠肿瘤，在肝脏和肠系膜中观察到多处转移。组织病理学检查显示为转移性空肠绒毛膜癌。患者无男子女性型乳房，睾丸正常。血清β-人绒毛膜促性腺激素（HCG）水平异常升高，达4396 ng/mL。由于发生脑转移和气管侵犯，他在术后第20天死亡。我们报告了这例罕见的男性患者，其绒毛膜癌从纵隔转移至胃肠道，并对相关文献进行了综述。
