Gynecomastia Attributable to Human Chorionic Gonadotropin-Secreting Giant Cell Carcinoma of Lung

Yaturu, Subhashini; Harrara, Elba; Nopajaroonsri, Charan; Singal, Rakesh; Gill, Sarjit S.

doi:10.4158/ep.9.3.233

Cited by 19 publications

(8 citation statements)

References 12 publications

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“…Another important issue in our case is, elevated serum βhCG levels were associated with clinically significant gynecomastia. Gynecomastia is reported in some gonadal and extragonadal originated cancer types as a paraneoplastic syndrome [9, 10]. But again to our knowledge our case is also the first case with gynecomastia in pleomorphic carcinoma of the lung.…”

Section: Discussionsupporting

confidence: 53%

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

et al. 2010

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Although gynecomastia is a well-defined paraneoplastic syndrome in patients with non-small cell lung cancer, the association with pleomorphic carcinoma has not been reported. A 50-yr-old man presented with bilateral gynecomastia and elevated serum beta-human chorionic gonadotropin (βhCG) level. Chest tomography showed a mass in the right middle lobe. Right middle lobectomy and mediastinal lymph node dissection were performed. βhCG levels decreased rapidly after surgery. Histological examination revealed pleomorphic carcinoma with positive immunostaining for βhCG. Serum βhCG levels began to increase gradually on postoperatively 4th month. Computed tomography detected recurrence and chemotherapy was started. After second cycle of chemotherapy, βhCG levels decreased dramatically again and tomography showed regression in mass. Patient died 6 months later due to brain metastasis. βhCG expression may be associated with aggressive clinical course and increased risk of recurrence, also βhCG levels may be used to evaluate therapy response in patients with pleomorphic carcinoma.

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Section: Discussionsupporting

confidence: 53%

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

et al. 2010

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“…5,7 Of note, giant cell carcinoma is often characterized by peripheral neutrophilia and fever due to production of granulocyte colony-stimulating factor (G-CSF) or other paraneoplastic symptoms. 43,44 A summary of the most characteristic features of patients with PSC is reported in Table 1. As conventional NSCLC, PSC may metastasize through lymphatic channels and blood vessels leading to usual distant metastases (i.e., brain, bone, adrenal gland, liver), but unusual sites (i.e., pancreas, and kidney) and involvement of the digestive tract are not infrequent.…”

Section: Epidemiology Imaging Studies Clinical Featuresmentioning

confidence: 99%

<p>Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma</p>

Baldovini¹,

Rossi²,

Ciarrocchi³

2019

LCTT

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Pulmonary sarcomatoid carcinoma (PSC) is a heterogeneous category of primary lung cancer accounting from 0.3% to 3% of all primary lung malignancies. According to the most recent 2015 World Health Organization (WHO) classification, PSC includes several different variants of malignant epithelial tumors (carcinomas) histologically mimicking sarcomas showing or entirely lacking a conventional component of non-small cell lung cancer (NSCLC). Thus, this rare subheading of lung neoplasms includes pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, pulmonary blastoma, and carcinosarcoma. A diagnosis of PSC may be suspected on small biopsy or cytology, but commonly requires a surgical resection to reach a conclusive definition. The majority of patients with PSC consists of elderly, smoking men with a large, peripheral mass characterized by well-defined margins. However, presentation with a central, polypoid endobronchial lesion is well-documented, particularly in pleomorphic carcinoma and carcinosarcoma showing a squamous cell carcinoma component. As expected, PSC may pose diagnostic problems and immunohistochemistry is largely used when pathologists deal these tumors in routine practice. Indeed, PSC tends to overexpress molecules associated with the epithelial-to-mesenchymal transition, such as vimentin, but the panel of immunostains also includes epithelial markers (cytokeratins, EMA), TTF-1, p40 and negative markers (e.g., melanocytic, mesothelial and sarcoma-related primary antibodies). Although rare, PSC has increased their interest among oncologist community for different reasons: a. identification of the epithelial-to-mesenchymal phenomenon as a major mechanism of secondary resistance to tyrosine kinase inhibitors; b. over-expression of PD-L1 and effective treatment with immunotherapy; c. identification of c-MET exon 14 skipping mutation representing an effective target to crizotinib and other specific inhibitors. In this review, the feasibility of the diagnosis of PSC, its differential diagnosis and novel molecular findings characterizing this group of lung tumor are discussed.

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“…Tumour-associated b-human chorionic gonadotrophin (hCG) production has been demonstrated in SCLCs and PICTs clinically associated with gynaecomastia in men, menstrual irregularity and virilisation in women, and precocious puberty in children (Braunstein et al 1972, DeLellis & Xia 2003, Yaturu et al 2003, Mehta et al 2008). An hCG-like protein is also found in a variety of normal tissue, and there is evidence to suggest that the a-hCG subunit may exert a paracrine effect on the growth of tumour cells (Rivera et al 1989), whereas b-hCG has been thought to act as a growth factor in SCLCs (Szturmowicz et al 1995).…”

Section: Ectopic Secretion Of Other Peptide Hormonesmentioning

confidence: 99%

Paraneoplastic syndromes secondary to neuroendocrine tumours

Kaltsas

Androulakis²,

Herder³

et al. 2010

Endocrine-Related Cancer

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Neuroendocrine tumours may be either benign or malignant tumours, and have the ability to synthesise and secrete biologically active substances characteristic of the cell of origin that can cause distinct clinical syndromes. The term 'paraneoplastic syndromes' (PNSs) is used to denote syndromes secondary to substances secreted from tumours not related to their specific organ or tissue of origin and/or production of autoantibodies against tumour cells; such syndromes are mainly associated with hormonal and neurological symptoms. Appreciation of the presence of such syndromes is important as clinical presentation, if not identified, may delay the diagnosis of the underlying neoplasia. Conversely, early recognition can allow for more rapid diagnosis, particularly as the coexistence of a neoplasm with a clinical or biochemical marker offers an additional determinant of tumour status/progression. PNSs can complicate the patient's clinical course, response to treatment, impact prognosis and even be confused as metastatic spread. Their diagnosis involves a multidisciplinary approach, and detailed endocrinological, neurological, radiological and histological studies are required. Correct diagnosis is essential as the treatment of choice will be different for each disorder, particularly in the case of malignant tumours; it is therefore important to develop appropriate means to correctly identify and localise these tumours. Clinical awareness and the incorporation into clinical practise of 111 In-octreotide scintigraphy, chromogranin A and other evolving biochemical marker measurement techniques have substantially contributed to the identification of patients harbouring such syndromes. Diseasespecific medical therapies are mandatory in order to prevent recurrence and/or further tumour growth. Owing to their rarity, central registration of these syndromes is very helpful in order to be able to provide evidence-based diagnostic and therapeutic approaches.

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Gynecomastia Attributable to Human Chorionic Gonadotropin-Secreting Giant Cell Carcinoma of Lung

Cited by 19 publications

References 12 publications

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

<p>Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma</p>

Paraneoplastic syndromes secondary to neuroendocrine tumours

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