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Review
. 2016 Dec;95(52):e5693.
doi: 10.1097/MD.0000000000005693.

Primary Pulmonary Choriocarcinoma in a Male That Was Successfully Diagnosed and Treated: A Case Report and Review of the Literature

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Free PMC article
Review

Primary Pulmonary Choriocarcinoma in a Male That Was Successfully Diagnosed and Treated: A Case Report and Review of the Literature

Ran Zhu et al. Medicine (Baltimore). .
Free PMC article

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.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1
CT scan of the chest. (A) Soft tissue window: A fairly well demarcated left pulmonary mass is adjacent to the pleura and compressed the left oblique crack to camber. (B) Axial 5-mm-thick reconstructed lung window: A well-defined 8 × 6 cm lobulated inhomogenous mass can be seen in the upper lobe of the left lung.
Figure 2
Figure 2
Macroscopic and histologic features of the tumor. (A) Gross specimen compressing the adjacent lung tissue. (B) At low magnification, the tumor cells grow in clusters with a large area of hemorrhage and necrosis (hematoxylin and eosin; original magnification, ×12.5). (C) The cytotrophoblastic cells grow in clusters separated and capped by giant syncytiotrophoblastic cells, thereby forming the characteristic biphasic pattern surrounded by a hemorrhagic area (hematoxylin and eosin; original magnification, ×100). (D) Higher magnification emphasizes the peripheral palisading by bizarre syncytiotrophoblasts (hematoxylin and eosin; original magnification, ×200).
Figure 3
Figure 3
Immunohistochemical findings of PPC. (A) The PPC cells are positive for CD10. (B) The PPC cells are positive for GATA3. (C) The tumor cells are weakly focal positive for P63. (D) Syncytiotrophoblastic giant cells and a few cytotrophoblastic cells are positive for β-HCG. (E) The tumor cells are negative for TTF-1. (F) The Ki-67 labeling index is 75% in the tumor cells (immunohistochemical staining; original magnification, ×100). β-HCG = Beta-human chorionic gonadotropin, PPC = primary pulmonary choriocarcinoma, TTF-1 = thyroid transcription factor-1.

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