Coexistence of choriocarcinoma and hepatoid adenocarcinoma in the stomach.

The case is presented of a 46 year old woman who had a gastric tumor with components of choriocarcinoma, hepatoid adenocarcinoma and common types of adenocarcinoma. Although two histologic types of tumor producing carcinoplacental or carcinofetal proteins were contained within the tumor, immunohistochemical analyses, especially of placental alkaline phosphatase, clearly showed that each component was present separately within the same tumor. It was only hepatoid adenocarcinoma cells that permeated the lymph and blood vessels. After the recurrence, the serum level of alpha-fetoprotein (AFP) markedly elevated, but that of human chorionic gonadotropic beta-subunit (hCG-beta) was always within normal range. These findings indicate that in the present case the hepatoid adenocarcinoma component was more aggressive in growth than the choriocarcinoma component.