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. 2014:2014:268919.
doi: 10.1155/2014/268919. Epub 2014 Oct 1.

Her2+ and b-HCG Producing Undifferentiated Gastric Adenocarcinoma

Sahar Eivaz-Mohammadi  1 , Fernando Gonzalez-Ibarra  1 , Waheed Abdul  2 , Omer Tarar  1 , Khurram Malik  1 , Amer K Syed  3
Affiliations

Her2+ and b-HCG Producing Undifferentiated Gastric Adenocarcinoma

Sahar Eivaz-Mohammadi et al. Case Rep Med. 2014.

Abstract

A 25-year-old Hispanic female with a history of anemia, schizoaffective disorder, and psychosis was admitted for anemia associated with fatigue, weakness, shortness of breath, night sweats, weight loss, and abdominal and lower back pain for the past two months. On routine management, she was found to have a positive serum b-HCG of 80.4 (0-5 mIU/mL) but the patient denied any sexual activity in her life. During her admission, U/S of the pelvis was noncontributory. CT angiogram of the chest was significant for prominent mediastinal and hilar lymph nodes, diffusely thickened stomach suggesting gastric malignancy with multiple hypoenhancing lesions in the liver and diffuse lytic lesions in the spine and sacrum suspicious for metastatic disease. The MRI of the abdomen confirmed the CT angiogram findings. After these findings, EGD was performed which showed lesions in the antrum, body of the stomach, fundus, and cardia on the lesser curvature of the stomach body correlating with carcinoma. The biopsy was positive for Her2, b-HCG producing poorly differentiated gastric adenocarcinoma. Patient underwent one successful round of chemotherapy with Taxotene, Cisplatin, and 5-FU for Stage IV gastric adenocarcinoma.

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Figures

Figure 1
Figure 1
Incidental finding of thickening of stomach lining (asterisk), multiple liver and spinal metastases (arrows) found in the CT with contrast angiogram of the chest.
Figure 2
Figure 2
MRI with and without contrast of the abdomen showing at least two liver metastases, stomach thickening, and spinal metastasis.
Figure 3
Figure 3
Esophagogastroduodenoscopy showing lesions in the antrum, body of the stomach, fundus, cardia, and the lesser curvature of the stomach body consistent with carcinoma.
Figure 4
Figure 4
Histopathology of gastric cells. (a) Shows normal gastric cells consisting of mucous cells, parietal cells, and chief cells. (b), (c), and (d) Show undifferentiated adenocarcinoma gastric tumor cells.
Figure 5
Figure 5
Histopathology of undifferentiated gastric tumor cells stained positive for b-HCG.
Figure 6
Figure 6
(a) The arrow indicates normal gastric cells (unstained) and asterisk shows Her2+ stained cancerous cells. (b) Shows Her2+ stained gastric cancerous cells.
See this image and copyright information in PMC

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