Choriocarcinoma of unknown origin with multiple organ metastasis and cerebral hemorrhage: A case report and literature review

Wei, Hongtao; Zhang, Tianpeng; Liu, Bing; Xue, Xiang; Wang, Guoxing

doi:10.3892/ol.2016.4463

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…In fact, syncytiotrophoblast in vitro are known to express Tissue Factor, the clotting initiator, and choriocarcinomas may be associated with thrombosis . It should be noted that both the absence of a tumor circulation on angiography and a lack of FDG‐glucose uptake on PET may argue against a diagnosis of cerebral metastasis. However, no tumor circulation is established in choriocarcinomas, and this might explain the negative imaging studies .…”

Section: Discussionmentioning

confidence: 99%

“…Cases of gestational, gonadal nongestational, or extragonadal primary choriocarcinomas in the liver, kidney, lung, or brain presenting with neurological impairment compatible with brain metastasis with intracranial hemorrhage have been reported . However, primary mediastinal choriocarcinoma is rare, and most often presents with symptoms such as coughing and chest pain .…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Cases of gestational, 12 gonadal nongestational, 13 or extragonadal primary choriocarcinomas in the liver, 14 kidney, 15 lung, 16 or brain 17 presenting with neurological impairment compatible with brain metastasis with intracranial hemorrhage have been reported. [18][19][20][21][22] However, primary mediastinal choriocarcinoma is rare, and most often presents with symptoms such as coughing and chest pain. 21,[23][24][25][26] It is exceedingly rare for a primary mediastinal choriocarcinoma to present as TIA or stroke, as reported for this patient.…”

Section: P a T H O L O G Ymentioning

confidence: 99%

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Incidental primary mediastinal choriocarcinoma diagnosed by endobronchial ultrasound‐guided fine needle aspiration in a patient presenting with transient ischemic attack and stroke

Francischetti

Cajigas

Suhrland

et al. 2017

Diagnostic Cytopathology

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We describe a case of a 41-year old male patient with no significant prior medical history who presents with symptoms of Transient Ischemic Attack and stroke. Magnetic Resonance Imaging (MRI) of the brain identified areas of ischemia in the left side, and angiography showed occlusion of the left Medial Cerebral Artery (MCA). Cardiac Transthoracic Echocardiogram (TTE) for stroke evaluation incidentally noted a mediastinal abnormality leading to cancer work-up. Computer Tomography (CT) and F-fluorodeoxyglucose (FDG) PET-CT scan of the chest incidentally revealed an avid 6 cm paraesophagial/subcarinal mass. Further diagnostic work-up with endoscopic and endobronchial ultra sound (EBUS)-guided fine needle aspiration (FNA) of the mass yielded a cytology diagnosis of Germ Cell Tumor (GCT), with choriocarcinoma component. Additionally, high plasma levels of β-human chorionic gonadotrophin (β-HCG) were detected with no evidence of testicular tumor. This exceedingly rare presentation for a primary mediastinal choriocarcinoma underscores the importance of complete investigation of young patients presenting with neurological symptoms compatible with ischemic events. Diagn. Cytopathol. 2017;45:738-743. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: P a T H O L O G Ymentioning

confidence: 99%

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Incidental primary mediastinal choriocarcinoma diagnosed by endobronchial ultrasound‐guided fine needle aspiration in a patient presenting with transient ischemic attack and stroke

Francischetti

Cajigas

Suhrland

et al. 2017

Diagnostic Cytopathology

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“…It has been reported that the level of serumβ-HCG is elevated in different kinds of tumors, including renal cell carcinoma, [ 15 ] cervical squamous carcinoma, [ 16 ] ovarian cancer, [ 17 ] choriocarcinoma, [ 18 ] endometrial carcinoma, [ 19 ] sigmoid carcinoma, [ 20 ] lung cancer, [ 21 ] and so on.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal metastatic poorly differentiated carcinoma with β-human chorionic gonadotropin secretion presenting as a psoas abscess

Wang

Liu²,

Shao³

et al. 2017

Medicine

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Rationale:Psoas abscesses generally arise from a contiguous intra-abdominal or pelvic infectious process or hematogenous spreading of bacteria. The serum β-human chorionic gonadotropin has been used to detect normal or ectopic pregnancy. It also can be utilized in following up carcinomas.Patient concerns:Here, we reported a case of a 47-year-old woman who presented with a left psoas mass presumptively diagnosed as an abscess secondary to lumbar tuberculosis In addition, the patient had abnormal increase of β-human chorionic gonadotropin. The computed tomography (CT) scan and magnetic resonance imaging (MRI) showed that the 5th lumbar vertebral infection or tuberculosis with left psoas abscess. CT-guided percutaneous biopsy, surgical exploration and biopsy, and 18F-FDG (fluorodeoxyglucose) positron emission tomography-CT (PET-CT) were used to make a definite diagnosis. The sigmoidoscopy and biopsy were used to further diagnose.Diagnoses:The biopsy of left psoas demonstrated metastatic or infiltrating poorly differentiated carcinoma with secretion of β-human chorionic gonadotropin. The subsequent pathological examination of neoplasm showed the same pathologic morphology.Interventions:Appropriate treatment of infected retroperitoneal mass, systematic chemotherapy and cancer biotherapy for metastatic poorly differentiated carcinoma were taken.Outcomes:Interventions provided little help until the patient died of secondary infection and multiple organ failure.Lessons:This case represents an extremely unusual clinical presentation of metastatic poorly differentiated carcinoma with secretion of β-human chorionic gonadotropin presenting as a psoas abscess. Physicians also need to sharpen their awareness of the potential malignant carcinomas mimicking psoas abscess.

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Pancreatic Choriocarcinoma with Multiple Metastases: a Case Report and Literature Review

Youn¹,

Park²,

Woo³

et al. 2017

Korean J Pancreas Biliary Tract

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A 35-year-old Qatari man presented to our hospital with a 4-month history of mild abdominal pain, weight loss, and jaundice. He was found to have central intra-abdominal mass and a single testis in the scrotum. His investigations showed cholestatic jaundice and very high level of -HCG (1131379 IU/L). CT scans of the chest and abdomen showed a huge pelvic-abdominal mass with extensive retroperitoneal lymphadenopathy, in addition to liver and lung metastases. CT-guided Tru-Cut biopsy of the mass showed mixed germ cell tumor. Chemotherapy was refused by the patient and his family. In the following days, the patient bled from his liver metastases leading to hemorrhagic shock, hemorrhage from metastatic sites of choriocarcinoma containing tumors is named choriocarcinoma syndrome. He was transferred to the medical intensive care unit, where he was intubated and resuscitated. Embolization of the right hepatic artery was done, but failed to control the bleeding, which continued with development of disseminated intravascular coagulopathy and a severe abdominal compartment syndrome, and eventually the patient died.

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Choriocarcinoma of unknown origin with multiple organ metastasis and cerebral hemorrhage: A case report and literature review

Abstract: Abstract.A 26-year-old man was admitted to Beijing

Cited by 3 publications

References 11 publications

Incidental primary mediastinal choriocarcinoma diagnosed by endobronchial ultrasound‐guided fine needle aspiration in a patient presenting with transient ischemic attack and stroke

Incidental primary mediastinal choriocarcinoma diagnosed by endobronchial ultrasound‐guided fine needle aspiration in a patient presenting with transient ischemic attack and stroke

Retroperitoneal metastatic poorly differentiated carcinoma with β-human chorionic gonadotropin secretion presenting as a psoas abscess

Pancreatic Choriocarcinoma with Multiple Metastases: a Case Report and Literature Review

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