Beta-human chorionic gonadotropin expression in recurrent and metastatic giant cell tumors of bone: a potential mimicker of germ cell tumor

Int J Surg Pathol. 2014 Oct;22(7):617-22. doi: 10.1177/1066896914534466. Epub 2014 May 15.

Abstract

Giant cell tumors of bone (GCTs) are generally benign, locally aggressive neoplasms that rarely metastasize. The beta subunit of human chorionic gonadotropin (beta-hCG) is expressed in syncytiotrophoblasts and several nongynecologic neoplasms but has not been described in GCT. At our institution, we observed cases of elevated beta-hCG in patients with GCT leading to diagnostic difficulty and in one case, concern for metastatic choriocarcinoma. This study aims to determine the frequency of beta-hCG expression in GCT and any relationship to clinical aggressiveness. We evaluated tissue expression of beta-hCG by immunohistochemistry with 58% of cases staining for beta-hCG. Additionally, 2 of 11 patients with available serum and/or urine beta-hCG measurements demonstrated elevated beta-hCG due to tumor. It is important to be aware of beta-hCG expression by GCT and the potential for elevated urine and serum beta-hCG levels in patients with GCT so as to avoid misdiagnosis of pregnancy or gestational trophoblastic disease.

Keywords: beta-human chorionic gonadotropin; choriocarcinoma; giant cell tumor of bone.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / blood
  • Bone Neoplasms / diagnosis*
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Diagnosis, Differential*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Giant Cell Tumor of Bone / blood
  • Giant Cell Tumor of Bone / diagnosis*
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasms, Germ Cell and Embryonal / diagnosis*
  • Recurrence
  • Young Adult

Substances

  • Chorionic Gonadotropin, beta Subunit, Human