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[An advanced gastric cancer with varied histopathologic features including a choriocarcinoma: report of a case].

A 77-year-old male, complaining of epigastralgia, was admitted to hospital. An upper GI series revealed a hemispheric filling defect at the greater curvature of the lower gastric body and two submucosal tumor-like lesions of the antrum. Closer inspection revealed a tumor measuring 60 x 42 mm, with an irregular ulcer, and two submucosal tumor-like lesions with bridging folds, measuring 42 x 28 mm and 20 x 14 mm, respectively. Histologically, the microscopic features in the ulcerated tumor showed a variety of tumor cells with clear PAS-positive cytoplasms and marked atypical nuclei forming glandular structures that predominated. Additionally, a clear cell carcinoma, a papillary adenocarcinoma, a signet-ring cell carcinoma, and a choriocarcinoma were partially seen. Finally, in the submucosal tumor-like lesions, diffuse small tumor cells with scanty PAS-positive cytoplasms without granular structures were seen.