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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 July-August;180(7-8):387-90

DOI: 10.23736/S0393-3660.20.04386-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Gastrointestinal hemorrhage from a bleeding gastric polyp: an initial manifestation of metastatic testicular choriocarcinoma in a young adult

Eric M. SIELOFF 1 , Tooba TARIQ 2, Muhammad E. REHMAN 1, Sachin GOYAL 3, Murray EHRINPREIS 3

1 Homer Stryker School of Medicine, Department of Internal Medicine, Western Michigan University, Kalamazoo, MI, USA; 2 School of Medicine, Department of Geriatrics, Indiana University, Indianapolis, IN, USA; 3 Division of Gastroenterology, Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA



Choriocarcinoma is a rare and aggressive form of testicular germ cell tumor. Metastasis to the gastrointestinal tract is uncommon, but when it occurs is localized to the small bowel in 95% of cases, followed by the esophagus, stomach and colon - making it an extremely rare cause of gastric hemorrhage. We described the case of a young adult male with metastatic testicular choriocarcinoma who initially presented with presyncope and melena and was found to have a hemoglobin level of 5.5 g/dL. Endoscopy revealed a bleeding gastric polyp along the greater curvature of the stomach, removed with snare cautery, for which histology showed metastatic testicular choriocarcinoma. The patient underwent a right radical orchiectomy followed by ifosfamide, etoposide and cisplatin chemotherapy. This case represents one of the few document cases of metastatic testicular choriocarcinoma presenting as a gastric hemorrhage.


KEY WORDS: Gastrointestinal hemorrhage; Stomach; Testicular neoplasms

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