Primary pulmonary choriocarcinoma

Abstract

BackgroundThe aim of the study was to establish whether there are different clinical entities of primary pulmonary choriocarcinoma (PPC) that deserve different diagnostic approach and the most optimal treatment.Patients and methodsA systematic review with PubMed search was conducted to identify studies that reported cases of PPC. The eligibility criteria were histological diagnosis of pulmonary choriocarcinoma and thorough examination of the reproductive organs to exclude potential primary choriocarcinoma in the gonads. Furthermore, to illustrate the review we additionally present a patient referred at our institution.Results55 cases (17 men) were included in the review with a median age of 34 years. Women with the history of gestational event showed better survival outcome than women without the history of gestational event. Patients treated with combined modality treatment (surgery and chemotherapy) survived longer than the patients without combined modality treatment. Furthermore, multivariate analysis of prognostic factors showed that the combined modality treatment had independent prognostic significance. Size of the tumour showed significant prognostic influence in univariate and multivariate analysis.ConclusionsPPC is an extreme rarity with variable clinical characteristics and outcome. It is important to capture and treat patients in the early stages of the disease. Women with the history of gestational event may show better survival, therefore genetic examination could help us to predict patient’s prognosis. Surgery followed by adjuvant chemotherapy appears to represent the best treatment for PPC.

A Case Report of Primary Pulmonary Choriocarcinoma in a Man: Successful Combination of Surgery and Chemotherapy

“…Due to the paucity of data related to PPC, there is no official guideline for treatment of this disease. Nevertheless, several studies have shown that the combination of surgery and chemotherapy represents a favorable treatment [5]. In this report, we present a male patient with PPC successfully treated with surgery followed by chemotherapy.…”

“…The diagnostic criteria for PPC include the following: (1) history of no gynecologic cancers; (2) isolated or predominant lesion detected in the lung after ruling out primary lesions in gonads; (3) high levels of β-hCG that return to normal after surgery or chemotherapy; and (4) the diagnosis of PPC is confirmed by pathology [3,5].…”

Treatment of primary choriocarcinoma of lung

“…Диагноз при этом установили только при аутопсии. В настоящее время, в доступной нам литературе, мы встретили лишь одно сообщение, отражающее описания сводного достаточно большого числа наблюдений -55 больных с первичной хориокарциномой легкого [4]. Среди них было 17 мужчин и 38 женщин.…”

“…Однако наилучшие показатели выжи ваемости были в группе больных, которым провели комбинированное ле-чение. Первый этап -хирургическое лечение, второйадъювантная химиотерапия [4]. Медиана выживаемости пациентов была 8 мес.…”

“…Медиана выживаемости пациентов была 8 мес. 1-, 2-, 5-летняя выживаемость составила 61, 57, 49% соответственно [4].…”