When cancer patients suddenly have a positive pregnancy test

BMJ Case Rep. 2017 Jul 1:2017:bcr2017220493. doi: 10.1136/bcr-2017-220493.

Abstract

We present the case of non-small cell lung cancer (NSCLC) in a 48-year-old woman with an active history of smoking. The patient initially presented to her general practitioner with a progressive swelling on the neck. Further investigations diagnosed a metastatic lung tumour, and palliative chemotherapy was started. After 5 months of treatment, by newly reported amenorrhoea, cautiously before a restaging CT scan of the abdomen, a pregnancy test was performed and was positive. Both the gynaecological examination and the hormonal panel yielded no signs of pregnancy. Immunohistochemically, staining of the tumour was strongly positive for β-subunit of human chorionic gonadotropin (β-hCG) suggesting that the tumour was responsible for high β-hCG levels.Paraneoplastic β-hCG secretion from adenocarcinomas is rare. In the literature, only a few such cases have been reported. Previous studies suggested that the ability to secrete β-hCG in tumours may correlate to some extent to chemoresistance and thus, to a worse prognosis.

Keywords: Lung cancer (oncology); Pathology.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / metabolism*
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / metabolism*
  • Chorionic Gonadotropin, beta Subunit, Human / metabolism*
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / metabolism*
  • Middle Aged
  • Pregnancy / metabolism
  • Pregnancy Tests*
  • Prognosis
  • Smoking / adverse effects
  • Tomography, X-Ray Computed / methods

Substances

  • Antineoplastic Agents
  • Chorionic Gonadotropin, beta Subunit, Human