Primary choriocarcinoma of the lung: Report of a case treated with intensive multimodality therapy and review of the literature

Abstract

Primary choriocarcinomas of the lung are extremely rare. Like choriocarcinomas elsewhere, they possess rapid growth ability and a high propensity to metastasize. There is minimal information available on the treatment of lung choriocarcinoma. In the case reported herein, neoadjuvant chemotherapy with 5-fluorouracil (5-FU) infusion, etoposide, and cisplatin induced a partial response permitting complete excision of a massive tumor of the right upper lobe involving the chest wall and superior vena cava. The patient relapsed with a metastasis to the brain that was surgically excised. Contralateral lung metastases were soon noted and responded well to systemic chemotherapy; yet the patient died of a new brain metastasis. To our knowledge, this is the first example of a primary choriocarcinoma of the lung treated with intensive multimodality therapy. The latter seems to offer a potential benefit if certain guidelines are followed.

Choriocarcinoma syndrome after resection of primary pulmonary choriocarcinoma: report of a case

“…Though chest CT revealed no pulmonary nodules suggestive of metastasis, we could make a definite diagnosis of choriocarcinoma syndrome from aspiration cytology. There is a report that combined modality therapy consisting of chemotherapy including bleomycin, etoposide, and cisplatin along with surgery and irradiation may result in a complete response [5]. Early recognition of choriocarcinoma syndrome and the urgent multimodality treatment consisted of surgery and chemotherapy might be beneficial.…”

Fine Needle Aspiration Cytology Findings of Primary Pulmonary Choriocarcinoma in a Male Patient

“…Urgently chemotherapy was started and the patient responded well to the standard protocol. Prognosis of PPC according to literature is worse than its testicular counterpart [5][6][7] but the present patient is doing relatively well possibly because the tumor is restricted to the lungs only. Cytomorphology of PCC parallels that of an undifferentiated highly malignant tumor.…”

“…The prognosis of pulmonary PCC, especially in males is very poor as compared to its testicular counterpart because hematogenous spread is usually common at the time of diagnosis. 2,5,6 Often the entity is misdiagnosed as more common diseases such as primary or secondary lung tumors, tuberculosis, pneumonia or lymphoma and thus potentially curative chemotherapy or surgery may be delayed. [5][6][7] Considering its rarity, prognosis and diagnostic difficulties FNAC definitely has a role in such cases!…”

“…2,5,6 Often the entity is misdiagnosed as more common diseases such as primary or secondary lung tumors, tuberculosis, pneumonia or lymphoma and thus potentially curative chemotherapy or surgery may be delayed. [5][6][7] Considering its rarity, prognosis and diagnostic difficulties FNAC definitely has a role in such cases! A 26 year-old non-smoker male with no significant medical or surgical history presented with the complaints of progressive shortness of breath, productive cough, night sweats, diminished appetite and unexplained weight loss for 4 weeks.…”

Primary pulmonary choriocarcinoma in a male that was successfully diagnosed and treated

“…However, some cases have been reported to emerge in the lung, gastrointestinal tract, brain, and liver. In the literature, only 29 cases of primary choriocarcinoma in lung have been reported in males, including 25 cases of choriocarcinoma, [1,3–11,13–19,21–22,24–26] 3 cases of choriocarcinoma combined with adenocarcinoma, [12,20,23] and 1 case of mediastinopulmonary choriocarcinoma, [2] which is even rarer and has a very poor prognosis compared to its counterpart in the midline structures according to the literature. Primary pulmonary choriocarcinoma (PPC) in males is easy to misdiagnose or delay the diagnosis; therefore, a potentially curative chemotherapy or surgery may also be delayed.…”