A Case of Human Chorionic Gonadotropin Producing Gastric Cancer

We report a case of human chorionic gonadotropin (HCG) producing gastric cancer with metastases to Virchow's lymph node and a paraaortic lymph node. A 65-year-old woman with cervical tumors was found in an excisional biopsy to have cancer metastasis confirmed based on a histological examination of the specimen. Immunological staining showed that the part with the cancer had cells positive for HCG. Gastrointestinal en-doscopy (GIE) and computed tomographic (CT) showed advanced HCG-producing gastric cancer with me-tastases to Virchow's lymph node and a paraaortic lymph node. Under a diagnosis of advanced HCG-producing gastric cancer with the above metastases, we administered TS-1 as neoadjuvant chemotherapy orally for 2 course. Since down staging was observed after the second course, total gastrectomy, splenectomy, and D2 lymphadenectomy were done. Histological findings confirmed the proposed diagnosis. Virchow' s lymph node swelling was observed on postoperative day (POD) 19 and thereafter. Despite repeated chemo-therapy with TS-1, the metastatic lesion in the lymph node enlarged rapidly and she died on POD 102.