A Rare Case of Primary Pulmonary Choriocarcinoma in a Male: Immunohistochemical Detection for Human Chorionic Gonadotropin, Epidermal Growth Factor (EGF) and EGF-Receptor.

Toda, Shuji; Inoue, Yuichi; Ishino, Toru; Yonemitsu, Nobuhisa; Terayama, Kiyomi; Miyabara, Shinichi; Sugihara, Hajime

doi:10.1507/endocrj.42.655

Cited by 17 publications

(13 citation statements)

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“…2) The tumor might be a testicular choriocarcinoma metastasis that regressed spontaneously 9. 3) The tumor might be a cancer that originally develops as a nontrophoblastic neoplasm and transforms into a choriocarcinoma 10. The latter theories seem more feasible with regard to explaining the occurrences of stomach and lung choriocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of 13 males with primary choriocarcinoma and review of the literature

Jiang¹,

Xiang²,

Feng³

et al. 2014

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ObjectiveTo analyze the management and prognosis of primary choriocarcinoma (PCC) in male patients.MethodsThe clinical records of males with PCC who were treated at Peking Union Medical College Hospital between 1990 and 2012 were analyzed retrospectively. The literature regarding this clinical condition was also reviewed.ResultsThe median survival interval of the 13 patients treated at Peking Union Medical College Hospital was 54 months (range, 6–115 months), and the 1- and 3-year survival rates were 53.8% and 43.1%, respectively. All patients were treated with surgery; 12 were treated with combined chemotherapy. After including 100 cases found in the literature, for a total of 113 patients, the median survival interval was 10 months (range, 6.4–13.6 months). The testis was the most common primary site (36.2%). Most patients (70.9%) had metastatic lesions at diagnosis. Univariate and multivariate analyses revealed that longer median overall survival was significantly associated with patient age <34 years old (48 months vs 10 months, odds ratio [OR] =0.47, P=0.029), the presence of other histological components (54 months vs 11 months, OR =0.54, P=0.011), and combined chemotherapy and surgical treatments (14 months vs 2.5 months, OR =0.18, P=0.002).ConclusionPCC is an extremely rare disease among men, and its prognosis is much worse than that of gestational choriocarcinoma. The complete resection of the primary site and metastases followed by chemotherapy seems to provide patients with the best chance at survival. Furthermore, additional chemotherapy cycles might facilitate better progress.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of 13 males with primary choriocarcinoma and review of the literature

Jiang¹,

Xiang²,

Feng³

et al. 2014

OTT

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“…Other scholars have suggested that the neoplasm could have arisen from metaplasia or the differentiation of somatic tumor cells similar to primary lung cancer. Additionally, Toda et al [16] proposed that epidermal growth factor might play an important role in an autocrine manner in tumor cells of PPC.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis is usually delayed until the patient is in the middle-late stage of the disease. Distant metastases are observed in many cases [11–12,14,16,19,23–25] at the time of diagnosis, and the overall prognosis is extremely poor. A total of 18 patients have data about their treatment: 6 patients were treated with surgery and chemotherapy; 4 were treated with chemotherapy alone; 2 were treated with surgery, chemotherapy, and radiotherapy; 1 was treated with surgery and radiotherapy; 2 were treated with surgery alone; and 3 patients did not receive treatment and died quickly.…”

Section: Discussionmentioning

confidence: 99%

Primary pulmonary choriocarcinoma in a male that was successfully diagnosed and treated

et al. 2016

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Introduction:Primary pulmonary choriocarcinoma (PPC) is extremely rare, especially in males. It is characterized by a poor response to therapy and shortened survival times. Here, we report a successful diagnosis and modified treatment for PPC in a male and a review of the literature.Case presentation:This case report describes a 67-year-old male who was discovered to have a left pulmonary mass. The patient underwent a pulmonary lobectomy. Pathological examination showed a poorly biphasic differential tumor. Immunostaining displayed that beta-human chorionic gonadotropin (β-HCG), CD10, and GATA3 were positive, and the increase of postoperative serum β-HCG secretion was also confirmed. Systemic and genital screening was performed, but other abnormal findings were not observed. The diagnosis of PPC was confirmed. Then, the patient received 4 cycles of modified chemotherapy according the condition of his body. The patient has been alive for >13 months without recurrence, and the level of serum β-HCG has already decreased to normal. In addition to reporting this case, we have also summarized the similar previously published cases.Conclusions:Currently, there is no standard treatment for PPC. A rapid and correct diagnosis is necessary. Surgery and modified chemotherapy, based on the physical condition of the patient, may currently be the best therapy for PPC.

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“…Not only immunohistochemical studies but serum levels of HCG have also been approved for the detection of PCC. [8][9][10] Here, FNAC was performed and cytomorphology was suggestive squamous cell carcinoma, based on the clumps of ghost cells/apoptotic cells and necrosis. Other possibilities were undifferentiated malignant tumor, large cell carcinoma, adenosquamous carcinoma, giant cell-rich or metaplastic carcinoma, anaplastic carcinoma, and pleomorphic undifferentiated sarcoma etc.…”

Section: 25-7mentioning

confidence: 99%

Fine Needle Aspiration Cytology Findings of Primary Pulmonary Choriocarcinoma in a Male Patient

Samanta¹

2017

ACP

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Extragonadal germ cell tumors (EGCT) account for 2-5% of all germ cell tumors.1 Choriocarcinoma in male subjects is one of the non-seminomatous EGCT that occurs in relatively young individuals. Primary (extragonadal) choriocarcinoma (PCC) commonly arises in the retro peritoneum, mediastinum and brain.2 Metastasis to the lung is common, but PCC originating in the lung is extremely rare. Cytological features of PCC have been described only occasionally. 3,4Here we describe a case of a 26 years old male where the differential diagnosis of PCC was offered after FNAC (fine needle aspiration cytology) and subsequently it was confirmed histologically and immunohistochemically. The prognosis of pulmonary PCC, especially in males is very poor as compared to its testicular counterpart because hematogenous spread is usually common at the time of diagnosis. 2,5,6 Often the entity is misdiagnosed as more common diseases such as primary or secondary lung tumors, tuberculosis, pneumonia or lymphoma and thus potentially curative chemotherapy or surgery may be delayed. [5][6][7] Considering its rarity, prognosis and diagnostic difficulties FNAC definitely has a role in such cases! A 26 year-old non-smoker male with no significant medical or surgical history presented with the complaints of progressive shortness of breath, productive cough, night sweats, diminished appetite and unexplained weight loss for 4 weeks. Sputum for AFB (Acid-Fast Bacilli) was negative.Mantoux test was negative. No history of hemoptysis, chest pain, fever or chills was present. The patient did not respond to routine antibiotics. Chest examination revealed diffuse coarse inspiratory crackles. Genital exam did not reveal any scrotal mass. Laboratory data revealed raised ESR, neutrophilic leucocytosis, normal liver function tests and alpha-fetoprotein level. HIV 1 and 2 were nonreactive. Chest x-ray showed bilateral pulmonary cannon-ball nodules. Computed tomography (CT) demonstrated multiple cannonball lesions of variable sizes in both lung fields largest one measuring 8x7x5cm without enlargement of intrapulmonary or mediastinal lymph nodes ( Figure 1A) that first raised the suspicion of a germ cell tumor.FNAC under CT-guidance ( Figure 1B) was suggestive of nonsmall cell carcinoma possibly squamous cell carcinoma with extensive necrosis ( Figures 1C & 1D). The cellularity was poor and the fields were predominated by hemorrhage and large areas of coagulative necrosis and ghost cells resembling anucleate squames ( Figures 1C & 1D). Many apoptotic and degenerated cells and cells with cytoplasmic orangeophilia were identified (Figure 1d) but practically no inflammatory cells! The tumor cells were large, undifferentiated, highly pleomorphic with clumped chromatin, indistinct nucleoli and multivacuolated abundant cytoplasm (Figures 2A-2C). Bi and multinucleated cells were present. Screening for additional mass including CT scan of the retroperitoneum, abdomen, scrotum, brain and spine showed no abnormality. Serum levels of Human chorionic gonadotrophin (β-HCG)...

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A Rare Case of Primary Pulmonary Choriocarcinoma in a Male: Immunohistochemical Detection for Human Chorionic Gonadotropin, Epidermal Growth Factor (EGF) and EGF-Receptor.

Cited by 17 publications

References 13 publications

Clinical analysis of 13 males with primary choriocarcinoma and review of the literature

Clinical analysis of 13 males with primary choriocarcinoma and review of the literature

Primary pulmonary choriocarcinoma in a male that was successfully diagnosed and treated

Fine Needle Aspiration Cytology Findings of Primary Pulmonary Choriocarcinoma in a Male Patient

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