Gynecomastia and Ectopic Human Chorionic Gonadotropin Production by Transitional Cell Carcinoma of the Bladder

Abstract

We report a patient with gynecomastia and ectopic production of human chorionic gonadotropin (HCG) by a transitional cell carcinoma of the bladder. In the present case, serum HCG levels and gynecomastia paralleled the clinical course. On admission, the patient was suffering from invasive transitional cell carcinoma (grade 3) of the bladder with metastasis to the left inguinal lymph nodes, together with gynecomastia. The serum HCG level was also elevated. After anticancer chemotherapy, the apparent bladder lesion and gynecomastia disappeared, and the serum HCG level declined to within normal limits. About 2 months after discharge, when the patient suffered from recurrent invasive tumors of the bladder, gynecomastia reappeared and the serum HCG level again became elevated. Β-HCG was demonstrated in biopsy tissue using the immunoperoxidase technique. The presence of Β-HCG was always focally demonstrated and was shown to be localized in the cytoplasm of the tumor cells.

Multiple endocrine disorders manifested as gynecomastia in a patient with renal pelvis cancer

“…Ectopic production of hCG by a highly malignant high-grade urinary bladder urothelial carcinoma is considered to be a well-established paraneoplastic syndrome. Elevation of serum hCG levels in patients with bladder carcinoma causing gynecomastia have also been reported (1,14,17). Most of these patients had high-grade malignancy and advanced disease.…”

Multiple endocrine disorders manifested as gynecomastia in a patient with renal pelvis cancer

“…Ectopic production of hCG by a highly malignant high‐grade urinary bladder urothelial carcinoma is considered to be a well‐established paraneoplastic syndrome. Elevation of serum hCG levels in patients with bladder carcinoma causing gynecomastia have also been reported 14–16 . Most of these patients had high‐grade malignancy and advanced disease.…”

“…Elevation of serum hCG levels in patients with bladder carcinoma causing gynecomastia have also been reported. 14 , 15 , 16 Most of these patients had high‐grade malignancy and advanced disease. There are also published reports on primary choriocarcinomas of the renal pelvis.…”