Pulmonary Metastatic Choriocarcinoma from a Burned-out Testicular Tumor

Abstract

A 54-year-old man was referred to our hospital because of progressive dyspnea. Chest computed tomography showed multiple nodular shadows with a peripheral ground-glass halo. His clinical condition continued to deteriorate with the development of progressive respiratory failure requiring mechanical ventilation. A histological examination of a transbronchial lung biopsy revealed choriocarcinoma. The patient died within nine days of admission. A histological examination of the right testis during an autopsy revealed a burned-out testicular tumor consisting of a teratoma and a fibrous scar. We herein report a rare case of pulmonary multiple metastatic choriocarcinoma originating from a burned-out testicular tumor.

Spontaneous testicular tumor regression: case report and historical review

“…The five reported cases were metastatic and diagnosed using the cytohistological results of the lesions, which, in addition to the clinical findings, laboratory and imaging studies, allowed us to formulate the primary testicular diagnosis and to indicate the corresponding radical orchiectomy. In the various reports, the macroscopic description of the testicles showing the partial or total tumour regression phenomenon, the presence of lesions that are hardened, whitened, fibrose, of scar aspect, in the form of nodules (singular or multiple), banded, linear or starred, is reported [3, 4, 7, 38, 63–65]. We found fibrosis scarring in every one of our cases.…”

Case Report: First-Line Immune Checkpoint Inhibitor Plus Chemotherapy for Oral Metastasis in a Patient with Ultra High-Risk Gestational Choriocarcinoma

“…Notably, GCC is characterized by a high propensity for metastasis, often before it is clinically apparent. Given the unique “burn out” hypothesis of CC, 15 it was possible that the primary tumour regressed early in the disease course, leaving only distant metastases, which easily resulted in confusion with other cancers. Here, we presented such an entity.…”

A case of ‘burned-out’ testicular choriocarcinoma presenting with prostatic metastasis

“…7 Choriocarcinoma is the most aggressive among the GCT, with the potential of metastasising early hematogenously. 8 Management of advanced disease is a multimodal approach based on carboplatin-based chemotherapy regimens, with radiotherapy and retroperitoneal lymph node dissection being alternative options. 9 GCT in the majority of the cases derive from the testes, presenting with regional or distant metastases in cases of advanced disease.…”

“…Furthermore, lymphoplasmacytic infiltration is seen sometimes within the scar, which supports the theory of GCT regression due to immunological mechanisms. 7,8 Many of the cases of burned-out testicular tumours have normal clinical evaluation with normal findings from palpation of the testicles. SUS can be of great assistance, as in many cases a nodule, a scar or testicular microlithiasis can be seen that may raise suspicion for further evaluation.…”

“…Furthermore, lymphoplasmacytic infiltration is seen sometimes within the scar, which supports the theory of GCT regression due to immunological mechanisms. 7,8…”