{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:28:05Z","timestamp":1787646485115,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>\n                    Primary rectal adenocarcinoma with extensive choriocarcinomatous differentiation is a rare neoplasm, with only sporadic cases reported worldwide. The prognosis is typically poor, and no standard therapy has been established for this tumor. We report a case of a 63-year-old woman who presented with lower abdominal and pelvic discomfort, as well as rectal bleeding. Endoscopy revealed a rectal tumor. She was diagnosed with primary rectal adenocarcinoma with extensive choriocarcinomatous differentiation, accompanied by liver metastasis and peritoneal carcinomatosis. The immunohistochemical profile demonstrated strong and diffuse positivity for keratin (AE1\/AE3), beta-human chorionic gonadotropin (\u03b2-HCG), p53, MYC, p16, and Ki-67. Molecular analysis indicated mutations in\n                    <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">TP53<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">PI3KCA<\/jats:italic>\n                    . Despite the tumor's profile, the serum \u03b2-HCG level was not elevated. A chemotherapy regimen for metastatic colorectal adenocarcinoma was initiated, but there was a poor response, with rapid tumor progression. The patient survived for only 5 months postdiagnosis. We discuss the histopathological, immunohistochemical, and molecular findings, emphasizing their relevance to the differential diagnosis of neoplasms with choriocarcinomatous differentiation.\n                  <\/jats:p>","DOI":"10.1177\/10668969231204956","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T02:23:33Z","timestamp":1698373413000},"page":"976-981","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Rectal Tumor With Extensive Choriocarcinoma Differentiation in a Woman With Lung, Liver and Disseminated Peritoneal Disease: A Primary Rectal Adenocarcinoma With Extensive Choriocarcinoma Differentiation or Primary Rectal Choriocarcinoma?"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7318-1330","authenticated-orcid":false,"given":"Isidro","family":"Machado","sequence":"first","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"},{"name":"Pathology Department, Patologika Laboratory, Hospital QuironSalud, Valencia, Spain"},{"name":"Pathology Department, University of Valencia, Valencia, Spain"},{"name":"Cancer CIBER (CIBERONC), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Carmen","family":"Mart\u00ednez La Piedra","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Mart\u00ednez de Juan","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda-Maia","family":"de Alc\u00e1ntara","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyes","family":"Claramunt","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Antonio","family":"L\u00f3pez-Guerrero","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Marhuenda","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Melian","sequence":"additional","affiliation":[{"name":"Instituto Valenciano de Oncolog\u00eda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3109\/00313029309066581"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/106689699510030207"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02355035"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2000.1089"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2004.06.005"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3393\/jksc.2007.23.4.274"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70204-8"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/2278-330X.130490"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-020-02544-0"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1078155219875510"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-18-4278"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2019-0207-OA"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.5858\/2010-0334-RSR1.1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.pgp.0000215294.45738.a4"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-1439(98)00030-1"},{"issue":"8","key":"e_1_3_2_17_2","first-page":"845","article-title":"Intramucosal stomach adenocarcinoma metastasizing as a large intraabdominal mass with focal choriocarcinomatous differentiation","volume":"5","author":"Fujiyoshi Y","year":"2012","unstructured":"Fujiyoshi Y, Jiang S, Feng X. 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