Breast Carcinoma with Choriocarcinomatous Features: A Case Report

Sung, Hyun-Jung; Maeng, Young-In; Kim, Minkyung; Lee, Sunjae; Kang, Sung Min; Bong, Jin Gu; Oh, Hoon-Kyu

doi:10.4048/jbc.2013.16.3.349

Cited by 8 publications

(16 citation statements)

References 13 publications

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“…The latter type are aggressive neoplasms for which the specific underlying genetic alterations are not well characterized. Somatic neoplasms with choriocarcinomatous differentiation are rare but have been described involving certain sites, including breast (4,5), lung (6,7), gastrointestinal tract [esophagus (8), stomach (9,10), colon (11,12)], urinary system (bladder; refs. 13,14), renal pelvis (15,16), and the female genital tract [uterine cervix; refs.…”

Section: Introductionmentioning

confidence: 99%

Lineage-Specific Alterations in Gynecologic Neoplasms with Choriocarcinomatous Differentiation: Implications for Origin and Therapeutics

Xing

Zheng

Pallavajjala

et al. 2019

Clinical Cancer Research

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Purpose: Choriocarcinoma is most commonly gestational (androgenetic or biparental) but can be of germ cell origin or can develop as a component of a somatic neoplasm (genetically related to the patient). The latter type are aggressive neoplasms for which the underlying genetic alterations are not well characterized. Experimental Design: To investigate the relationship between the different components of somatic neoplasms with choriocarcinomatous elements, the genetic differences between gestational and nongestational tumors, and identify potential targetable alterations, we analyzed 23 samples from 11 tumors, including five gynecologic-type somatic neoplasms with choriocarcinomatous differentiation (two to three different components each) and six pure choriocarcinomas, for somatic mutations, single-nucleotide polymorphisms, and PD-L1 expression. Results: In mixed tumors, gynecologic-type carcinoma components demonstrated lineage-characteristic and line-age-specific alterations, with choriocarcinomatous components sharing some of these as well as demonstrating novel alterations, supporting a clonal relationship with divergent differentiation of the choriocarcinoma from the somatic carcinoma. TP53 mutation only occurred in nongestational tumors. Diffuse PD-L1 expression was characteristic of choriocarcinoma in both pure and mixed tumors but not seen in the gynecologic-type carcinoma components. Conclusions: Given that the somatic carcinomatous and choriocarcinomatous components of mixed tumors have distinct genetic alterations and biomarker expression, separate analysis of these components is required to guide targeted therapy. High PD-L1 expression suggests a role for checkpoint inhibitor-based immunotherapy in tumors with a choriocarcinoma component. The underlying mechanisms by which cancer stem cells reprogram and initiate trophoblastic retrodifferentiation in some somatic tumors warrant further investigation.

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Section: Introductionmentioning

confidence: 99%

Lineage-Specific Alterations in Gynecologic Neoplasms with Choriocarcinomatous Differentiation: Implications for Origin and Therapeutics

Xing

Zheng

Pallavajjala

et al. 2019

Clinical Cancer Research

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“…Breast choriocarcinomas are very uncommon and can be divided into two varieties: breast cancer with choriocarcinomatous features (BCCF) and metastatic choriocarcinoma to the breast [2][3][4]. BCCF was first reported in 1981 by Saigo and Rosen in a 55-year-old female [1]. It is important to correctly differentiate between BCCF and metastatic breast choriocarcinoma because BCCF is an aggressive tumor with a poor prognosis [2].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Choriocarcinoma of the Breast: A Rare Entity

Aleem¹,

Qureshi²,

Babar³

et al. 2022

Cureus

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Breast neoplasms are becoming more common in the last few years. Among these masses, metastasis to the breast is rare. Extra-gestational choriocarcinoma is extremely rare among breast neoplasms. We intend to present a case of a 30-year-old female with complaints of breast and axillary lumps. She had a history of a previously treated uterine trophoblastic tumor. Subsequently, she underwent a trucut biopsy of the breast mass and the axillary node, revealing metastatic choriocarcinoma.

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“…NGCCs are exceedingly rare, arising from pluripotent germ cells in the gonads or midline structures (for example, mediastinum) or in association with poorly differentiated somatic carcinomas [ 2 ]. Primaries reported include lung, cervix, endometrium, breast, bladder, and gastrointestinal tract [ 2 , 4 , 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature

et al. 2018

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Introduction: Non-gestational choriocarcinoma (NGCC) is an extremely rare cancer. We report a case presenting in extremis. Case Report: A 39-year-old woman presented with type 1 respiratory failure with a 1-month history of breathlessness. Computed tomography (CT) revealed widespread metastatic disease involving the lungs, liver, pancreas, and breast. Serum β-human chorionic gonadotropin was markedly raised. Over 72 h, she deteriorated and was started on high-flow nasal cannula to facilitate discussions and for comfort. Histology from a breast biopsy suggested a choriocarcinoma, and she was commenced on etoposide and cisplatin. Unfortunately she continued to deteriorate and died on day 11 of admission. Molecular genotyping received post-mortem confirmed non-gestational choriocarcinomatous differentiation within a high-grade tumour. Discussion: NGCC carries a worse prognosis compared with gestational choriocarcinoma and is historically less chemosensitive. However, differentiation between these two diagnoses is challenging due to a lack of immuno-histochemical differences. The NGCC in this case was likely to have originated in the lung due to a 12-cm mass in the lingula, and extensive emphysema on CT. Primary pulmonary choriocarcinoma has a rapidly fatal course in the majority of patients. Conclusion: This is the only case to our knowledge of NGCC presenting in extremis, where an accurate diagnosis was not achieved pre-mortem. This also demonstrates the merit of non-invasive ventilation within palliation to facilitate communication and comfort.

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Breast Carcinoma with Choriocarcinomatous Features: A Case Report

Cited by 8 publications

References 13 publications

Lineage-Specific Alterations in Gynecologic Neoplasms with Choriocarcinomatous Differentiation: Implications for Origin and Therapeutics

Lineage-Specific Alterations in Gynecologic Neoplasms with Choriocarcinomatous Differentiation: Implications for Origin and Therapeutics

Metastatic Choriocarcinoma of the Breast: A Rare Entity

Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature

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