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

Abstract

Introduction:Primary pulmonary choriocarcinoma (PPC) is extremely rare, especially in males. It is characterized by a poor response to therapy and shortened survival times. Here, we report a successful diagnosis and modified treatment for PPC in a male and a review of the literature.Case presentation:This case report describes a 67-year-old male who was discovered to have a left pulmonary mass. The patient underwent a pulmonary lobectomy. Pathological examination showed a poorly biphasic differential tumor. Immunostaining displayed that beta-human chorionic gonadotropin (β-HCG), CD10, and GATA3 were positive, and the increase of postoperative serum β-HCG secretion was also confirmed. Systemic and genital screening was performed, but other abnormal findings were not observed. The diagnosis of PPC was confirmed. Then, the patient received 4 cycles of modified chemotherapy according the condition of his body. The patient has been alive for >13 months without recurrence, and the level of serum β-HCG has already decreased to normal. In addition to reporting this case, we have also summarized the similar previously published cases.Conclusions:Currently, there is no standard treatment for PPC. A rapid and correct diagnosis is necessary. Surgery and modified chemotherapy, based on the physical condition of the patient, may currently be the best therapy for PPC.

Incidence and prognosis factors of extragonadal choriocarcinoma in males: a population-based study

“… 3 Zhu et al’s literature review of primary pulmonary choriocarcinoma in males reflected only 29 cases reported by 2016. 5 In our study, the incidence of extragonadal choriocarcinoma in males estimated by SEER data was 0.022/100,000 people, and the incidence decreased from 1981.…”

Incidental primary mediastinal choriocarcinoma diagnosed by endobronchial ultrasound‐guided fine needle aspiration in a patient presenting with transient ischemic attack and stroke

“…Cases of gestational, gonadal nongestational, or extragonadal primary choriocarcinomas in the liver, kidney, lung, or brain presenting with neurological impairment compatible with brain metastasis with intracranial hemorrhage have been reported . However, primary mediastinal choriocarcinoma is rare, and most often presents with symptoms such as coughing and chest pain .…”

“…Negative tests included blood cultures, HIV, auto‐immune disease (e.g., ANA, SMA) and antiphospholipid antibody syndrome panels. CBC showed hemoglobin of 13–14 g/dl (ref .4 g/dl) and hematocrit of 41% (ref 41.5–50.1%); aPTT was consistently shortened at 24 s (ref .1–33.8 s). Alanine transferase was slightly elevated at 35–55 U/l (ref 0‐30 U/l).…”

“…Such aneurysms are postulated to occur because of partial destruction of the vessel wall occurring after necrotic tumor embolus lodges in the vessel. 10,11 Cases of gestational, 12 gonadal nongestational, 13 or extragonadal primary choriocarcinomas in the liver, 14 kidney, 15 lung, 16 or brain 17 presenting with neurological impairment compatible with brain metastasis with intracranial hemorrhage have been reported. [18][19][20][21][22] However, primary mediastinal choriocarcinoma is rare, and most often presents with symptoms such as coughing and chest pain.…”

A Case of Male Primary Pulmonary Choriocarcinoma

“…Patients with clinical data in publications were aged from 4 months to 77 years. [123] The median age of the patients was 53.1 years. Most patients had symptoms such as pleuritic pain, hemoptysis, dyspnea, cough, or precocious puberty, whereas 1 case was asymptomatic, and the tumor was discovered by chest roentgenogram.…”