Elevated hCG Outside of Pregnancy—Diagnostic Considerations and Laboratory Evaluation

Olsen, Tandy G.; Barnes, Amy A; King, Jeremy A.

doi:10.1097/01.ogx.0000281556.13788.61

Cited by 10 publications

(6 citation statements)

References 19 publications

(17 reference statements)

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“…Normal values for hCG at 22 weeks' gestation are approximately 20,000-40,000 IU/mL. Trophoblastic and nontrophoblastic neoplasms both have caused elevations in hCG levels [10]. Similarly, in malignant teratomas, elevated levels of alphafetoprotein (AFP) and hCG have been documented.…”

Section: Discussionmentioning

confidence: 96%

Anesthetic management of a parturient with fetal sacrococcygeal teratoma and mirror syndrome complicated by elevated hCG and subsequent hyperthyroidism

McCann

Emery

Vallejo

2009

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 96%

Anesthetic management of a parturient with fetal sacrococcygeal teratoma and mirror syndrome complicated by elevated hCG and subsequent hyperthyroidism

McCann

Emery

Vallejo

2009

Journal of Clinical Anesthesia

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“…Beyond its role in diagnostics, HCG is also used for treatment of hypogonadism while maintaining fertility. The exogeneous administration of HCG has increasingly been used as a popular weight loss drug either by intramuscular injection or via oral ingestion despite there being no evidence proving its efficacy 8. Other factors leading to potential spurious HCG elevations include marihuana intake,9 illicit substance use10 and iatrogenic hypogonadism after orchiectomy for germ cell tumours 11.…”

Section: Discussionmentioning

confidence: 99%

Elevated HCG and retroperitoneal adenopathy after clomiphene therapy for infertility

et al. 2022

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In the context of an elevated human chorionic gonadotropin (HCG) with enlarged retroperitoneal nodes and absent testicular tumours, clinicians will consider a diagnosis of extragonadal germ cell tumours. We report the case of a man in his thirties who while on treatment for subfertility with clomiphene citrate was noted to have enlarged retroperitoneal nodes and elevated HCG levels of 75 IU/L. Chemotherapy with bleomycin, etoposide and cisplatin originally planned was deferred when two separate retroperitoneal nodal biopsies returned as benign fibroadipose tissue and HCG levels spontaneously down-trended to 4 IU/L within 4 months of clomiphene citrate discontinuation. Follow-up imaging revealed regression of the retroperitoneal nodes.

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“…Under normal circumstances, the hormone is secreted by syncytiotrophoblastic cells of the placenta and therefore can be used as a marker of pregnancy. In the absence of pregnancy, elevations in the β subunit may result from pituitary production, exogenous administration, or neoplastic production (3). Typically, neoplastic sources of hCG are trophoblastic malignancies; nevertheless, various other nongynecologic tumors, including sarcomas and carcinomas of the lung, urinary tract, and gastrointestinal tract have all been found to be occasionally associated with hCG production and/or expression (4–6).…”

Section: Discussionmentioning

confidence: 99%

Βeta-Human Chorionic Gonadotropin Production Associated with Phyllodes Tumor of the Breast: An Unusual Paraneoplastic Phenomenon

Reisenbichler¹,

Krontiras

Hameed³

2009

The Breast Journal

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Phyllodes tumors (PTs) of the breast are uncommon and account for < 1% of all breast tumors. Most patients present with mass lesions; however, there are rare reports of patients presenting with paraneoplastic conditions such as hypoglycemia secondary to insulin-like growth factor II secretion. A 55-year-old woman presented with a rapidly enlarging left breast mass which ulcerated through the skin and invaded the underlying muscle. The serum beta-human chorionic gonadotropin (beta-hCG) level was found to be 58 mIU/mL preoperatively; this dropped to 2 mIU/mL after surgery. Mastectomy showed a 14.5-cm fibroepithelial neoplasm, the majority of which was composed of a cellular spindle/epithelioid-cell proliferation with the focal presence of elongated epithelial clefts consistent with a PT. In addition to the presence of unequivocal sarcomatous stromal overgrowth and prominent mitotic activity, there were areas of lace-like osteoid production by tumor cells, and a diagnosis of malignant PT with osteosarcomatous foci was rendered. Immunohistochemical studies showed focal beta-hCG expression within the epithelioid stroma of the tumor; expression of p63 and cytokeratin was only seen in the epithelial component and there was no expression of placental alkaline phosphatase in either component. Although beta-hCG expression/production has been described in many nontrophoblastic tumors (mostly carcinomas of various organs), to our knowledge this is the first case documenting this in a PT of the breast. Whether this intriguing finding represents an isolated association or has more significant implications remains to be determined.

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Elevated hCG Outside of Pregnancy—Diagnostic Considerations and Laboratory Evaluation

Cited by 10 publications

References 19 publications

Anesthetic management of a parturient with fetal sacrococcygeal teratoma and mirror syndrome complicated by elevated hCG and subsequent hyperthyroidism

Anesthetic management of a parturient with fetal sacrococcygeal teratoma and mirror syndrome complicated by elevated hCG and subsequent hyperthyroidism

Elevated HCG and retroperitoneal adenopathy after clomiphene therapy for infertility

Βeta-Human Chorionic Gonadotropin Production Associated with Phyllodes Tumor of the Breast: An Unusual Paraneoplastic Phenomenon

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