BetaHCG secretion by a pulmonary adenocarcinoma

Abstract

We report a rare case of metastatic non-small-cell lung cancer in a 43-year-old woman with a history of smoking. The tumor secreted human chorionic gonadotropin and its beta subunit (BetaHCG). The patient presented with amenorrhea, a positive pregnancy test and chest pain. A physical examination and investigations revealed no pregnancy, and it was determined that a paraneoplastic syndrome stemming from a pulmonary tumor was responsible for the secretion of BetaHCG. This secretion decreased with tumor response to chemotherapy. Only a few reports of paraneoplastic BetaHCG secretion can be found in the literature for several different cancers.

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

“…The encountered clinical scenario shared many similarities with a primary mediastinal non-seminomatous germ cell tumor (PMNSGCT) except for the patient's age. The reported median age for PMNSGCT is 30 years [6,13] . The rapid clinical progression in this patient raised the suspicion of a non-conventional case of non-small cell lung cancer which further prompted beta-HCG evaluation.…”

“…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.…”

“…Beta-HCG elevation is also seen secondary to ectopic secretion by non-trophoblastic tumor cells [9] . Ithas been reported as a paraneoplastic phenomenon in about 10% of primary lung cancer case [10][11][12][13][14] . Lung cancers with elevated beta-HCG are more resistant to chemotherapy and have poor prognosis.…”

Serum Biomarkers May Prognosticate Recurrence in Node-Negative, Non-Small Cell Lung Cancers Less Than 4 Centimeters

“…Although its differential expression has not been previously associated with prognosis in early stage NSCLC [21], this assessment was not in the context of a multivariate panel, where it may perform well in a particular subcohort. Beta-human chorionic gonadotropin is a serum protein used in the identification of some germ cell tumors that is known to play a vital role in embryogenesis, but it has only anecdotal accounts of prognostic value [30]. Follistatin is a member of the inhibin-activin-follistatin axis that has been shown to act in cellular proliferation and differentiation related to tissue repair.…”

Galactorrhea, mastodynia and gynecomastia as the first manifestation of lung adenocarcinoma. A case report

“…Although has been documented in cases with non–small-cell lung cancer (NSCLC) since 1967 [1], variably elevated b-HCG levels are detected in up to 50% of patients with NSCLC, in either serum or urine and may be a poor prognostic marker [2,3]. Since these initial observations, more than fifteen years ago, there has been an increasing number of reports in the literature supporting the use of b-HCG as a serum biomarker for NSCLC [[4], [5], [6]]. Subclinical elevations in prolactin have also been described in a minority of NSCLCs.…”