Secretion of hCG/beta-hCG by Squamous Cell Carcinoma of the Lung in a 31-year-old Female Smoker

Abstract

Abbreviations: hCG, human chorionic gonadotropin; β-hCG, β-subunit of human chorionic gonadotropin; SCC, squamous cell carcinoma; HB, hepatitis type B; NSCLC, non-small cell lung cancer We describe a rare case of pulmonary squamous cell carcinoma secreting human chorionic gonadotropin (hCG) and its β-subunit (β-hCG) in a young female smoker. A 31-year-old mother of one child had been suffering from dysfunctional uterine bleeding for about 1 year. Pelvic examinations and abdominal ultrasonography yielded no abnormal findings and no signs of pregnancy. She developed a pain in the right chest and a huge (12 × 10 cm) squamous cell carcinoma was diagnosed in the right lower lobe. The serum hCG and β-hCG levels were high: hCG 5611 mIU/ml (normal upper limit 0.7 mIU/ml), β-hCG 12 238 mIU/ml (normal upper limit 0.5 mIU/ml). The patient underwent right lower lobectomy and systematic lymph node dissection. Microscopic study showed a poorly differentiated squamous cell carcinoma. The pathological stage was T2N0M0, stage IB. Immunohistochemical staining of the tumor was strongly positive for hCG. The serum hCG level returned to normal 1 month after the operation, while an additional 2 months were necessary for the β-hCG level to normalize. Dysfunctional uterine bleeding disappeared and the patient is doing well, with no signs of recurrence, 9 months after the resection.

Elevated Serum β-Human Chorionic Gonadotropin in Nonpregnant Conditions

“…The hormone is detected in the serum or in the lung tissue itself (11)(12)(13)(14). Dirnhofer et al reported that in various types of lung cancers, ␣-hCG immunoreactivity was detected in 21 of 90 cases, and ␤-hCG in 6 of 90 (13).…”

β-HCG secretion by a non-small cell lung cancer: a case report

“…However, after modification of chemotherapy, a partial tumor response with a markedly decrease in β-HCG level was obtained. In another report, Yoshida et al described a case of pulmonary squamous cell carcinoma secreting β-HCG in a young female patient, in whom, after two months of surgery, the β-HCG dropped to normal levels (8).…”

Extragonadal Germ Cell Tumor in an Older Patient. Not Every Mass is a “Lung Cancer”.

“…Elevation of beta-HCG in lung cancer is rare. It has a reported incidence of 14% in small cell lung cancer and 28% in non-small cell lung cancer [12][13][14][15][16][17][18][19] . The reported elevation of beta HCG in lung cancer is about 20-3000 mIU/ml only.…”