Choriocarcinoma Syndrome: A Case Report and a Literature Review

Abstract

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 β-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.

Malignant epidural spinal cord compression secondary to testicular cancer (mixed choriocarcinoma and seminoma) in the immediate post radical orchidectomy period

“…He probably had choriocarcinoma syndrome. Baagar et al highlighted that hemorrhage can develop from any sites of metastases. Hence, we strongly believe that choriocarcinoma being a very vascular tumor its metastases are very vascular as well and that the sudden neurology deficit in this case may result from a hyperacute hemorrhage within an already vascular epidural metastatic tumor.…”

“…It occurs either spontaneously or few hours after initiation of chemotherapy. The prognosis is poor particularly with βhCG above 50 000 IU/L …”

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

“…Notably, no abnormalities were observed in the testicular physical exam. Choriocarcinoma usually undergoes vascular invasion and easily causes metastatic bleeding (4,5). A study by Baagar et al described choriocarcinoma syndrome as the hemorrhage of the tumor at its metastatic site.…”

Lumbar Vertebrae and Epidural Space Metastases of Choriocarcinoma: A Case Report

“…It is characterized by the high secretion of human chorionic gonadotropin (HCG), rapid invasion of surrounding tissues, and early hematogenous metastasis. The common sites of metastasis outside the pelvic are lung, liver, kidney, and gastrointestinal tract [3][4][5][6]. The vertebrae metastasis of choriocarcinoma is extremely rare [4].…”