Primary adenocarcinoma with choriocarcinomatous differentiation of the sigmoid colon misdiagnosed choriocarcinoma of the uterus: case report and review of the literature

Choriocarcinoma is a highly malignant tumor of trophoblastic cells that most often arises in the placenta, but may also develop in extragonadal tissues. Primary extragonadal choriocarcinoma, especially in the gastrointestinal tract, is extremely rare and is associated with poor prognosis. This report describes a 44-year-old Korean woman who was initially diagnosed incorrectly with choriocarcinoma of the uterus, but was ultimately diagnosed with primary adenocarcinoma accompanied by focal choriocarcinomatous differentiation in the sigmoid colon and secondary degeneration of submucosal myoma. Her progression was rapid and because of her poor general condition, she received only a single cycle of cisplatin chemotherapy. She died of multiorgan failure due to multiple metastases two months after the initial diagnosis.

Primary extragonadal choriocarcinoma; Adenocarcinoma; Submucosal myoma; Chemotherapy.

[1] Harada M., Inoue T., Hamano K.: “Choriocarcinoma of the sigmoid colon: report of a case”. Surg. Today, 2012, 42, 93.

[2] Park C.H., Reid J.D.: “Adenocarcinoma of the colon with choriocarcinoma in its metastases”. Cancer, 1980, 46, 570.

[3] Nguyen G.K.: “Adenocarcinoma of the sigmoid colon with focal choriocarcinoma metaplasia: a case report”. Dis. Colon Rectum, 1982, 25, 230.

[4] Kubosawa H., Nagao K., Kondo Y., Ishige H., Inaba N.: “Coexistence of adenocarcinoma and choriocarcinoma in the sigmoid colon”. Cancer, 1984, 54, 866.

[5] Metz K.A., Richter H.J., Leder L.D.: “Adenocarcinoma of the colon with syncytiotrophoblastic differentiation: differential diagnosis and implications”. Pathol. Res. Pract., 1985, 179, 419.

[6] Maehira H., Shimizu T., Sonoda H., Mekata E., Yamaguchi T., Miyake T., et al.: “A rare case of primary choriocarcinoma in the sigmoid colon”. World J. Gastroenterol., 2013, 19, 6683.

[7] Oh S.K., Kim H.W., Kang D.H., Choi C.W., Choi Y.Y., Lim H.K., et al.: “Primary Adenocarcinoma with Focal Choriocarcinomatous Differentiation in the Sigmoid Colon”. Korean J. Gastroenterol., 2015, 66, 291.

[8] Umemori Y., Hiraki A., Aoe K., Murakami T., Maeda T., Matsuda E., et al.: “Primary choriocarcinoma of the lung”. Anticancer Res., 2004, 24, 1905.

[9] Verbeek W., Schulten H.J., Sperling M., Tiesmeier J., Stoop H., Dinjens W., et al.: “Rectal adenocarcinoma with choriocarcinomatous differentiation: clinical and genetic aspects”. Hum. Pathol., 2004, 35, 1427.

[10] Le D.T., Austin R.C., Payne S.N., Dworkin M.J., Chappell M.E.: “Choriocarcinoma of the colon: report of a case and review of the literature”. Dis. Colon Rectum, 2003, 46, 264.

[11] Ordóñez N.G., Luna M.A.: ‘Choriocarcinoma of the colon”. Am. J. Gastroenterol., 1984, 79, 39.

[12] Kobayashi A., Hasebe T., Endo Y., Sasaki S., Konishi M., Sugito M., et al.: “Primary gastric choriocarcinoma: two case reports and a pooled analysis of 53 cases”. Gastric Cancer, 2005, 8, 178.

[13] Tokisue M., Yasutake K., Oya M., Nishisaki H., Nakashima T., Hasegawa H., et al.: “Coexistence of choriocarcinoma and adenocarcinoma in the rectum: molecular aspects”. J. Gastroenterol., 1996, 31, 431.