Elfiky Ahmed, Mokhtar Asmaa, Alsheikh Mira, Almoussawi Hassan, Mulrooney Stephen
Department of Internal Medicine, Staten Island University Hospital-Northwell Health, New York, NY, USA.
Department of Gastroenterology, Staten Island University Hospital-Northwell Health, New York, NY, USA.
Case Rep Gastrointest Med. 2021 Mar 2;2021:6664147. doi: 10.1155/2021/6664147. eCollection 2021.
Testicular tumors are one of the most common solid tumors in young males. Choriocarcinoma usually presents as metastatic disease. Gastrointestinal tract involvement is rare. We report a case of a 40-year-old male presenting to our hospital with a three-day history of dyspnea on exertion and black stool after recent diagnosis of testicular choriocarcinoma. Urgent EGD performed revealed small clean-based fundal ulcer and an antral ulcer without the stigma of recent bleeding. Capsule endoscopy was performed and revealed a bleeding ill-defined mass in the proximal duodenum. A subsequent push enteroscopy showed an ulcerated bleeding mass in the third part of the duodenum that was treated with a hemospray with adequate hemostasis. Pathology was consistent with pure choriocarcinoma. The patient received a cisplatin-based chemotherapy regimen. The patient tolerated the chemotherapy regimen well and was discharged for outpatient follow-up. At the three-month follow-up, the patient did not show evidence of recurrent gastrointestinal bleeding.
睾丸肿瘤是年轻男性中最常见的实体瘤之一。绒毛膜癌通常表现为转移性疾病。胃肠道受累情况罕见。我们报告一例40岁男性，近期诊断为睾丸绒毛膜癌后，因劳力性呼吸困难和黑便3天前来我院就诊。紧急上消化道内镜检查显示胃底有小的基底干净的溃疡和一个胃窦溃疡，无近期出血迹象。进行了胶囊内镜检查，发现十二指肠近端有一个边界不清的出血性肿物。随后的推进式小肠镜检查显示十二指肠第三段有一个溃疡出血性肿物，用止血喷雾进行治疗后止血充分。病理结果与纯绒毛膜癌一致。患者接受了以顺铂为基础的化疗方案。患者对化疗方案耐受性良好，出院进行门诊随访。在三个月的随访中，患者未出现胃肠道出血复发的迹象。
