Gynecomastia as Unusual Presentation of Primary Choriocarcinoma of the Colon: A Case Report and Literature Review

Abstract

Objective: Gynecomastia is the benign enlargement of male breast tissue and is the most common breast condition in males. Beta human chorionic gonadotropin (b-hCG)secreting tumors such as choriocarcinoma are one cause of gynecomastia. This is the first report of bilateral gynecomastia secondary to malignant b-hCG-secreting choriocarcinoma located in the colon. Methods: A 49 year-old male who presented bilateral gynecomastia was found to have a primary colonic choriocarcinoma. Results: Serum b-hCG levels were significantly high at 11.546 mIU/mL (normal range 0.01-5). A colonoscopy showed a stenosing mass in the sigmoid colon, and computed tomography revealed multiple liver metastases. The diagnosis of choriocarcinoma was confirmed by the histologic and immunohistochemical biopsy findings. Conclusion: Primary colorectal choriocarcinoma is a very rare entity that should be considered in the differential diagnosis of gynecomastia. (AACE Clinical Case Rep. 2015;1:e260-e264) Abbreviation: b-hCG = b human chorionic gonadotropin.