Male primary mediastinal choriocarcinoma with diffuse metastases

Qiu, Zhenhua; Wu, Yue; Wang, Yapeng; Hu, Chunhong

doi:10.1097/md.0000000000016411

Cited by 16 publications

(17 citation statements)

References 20 publications

(29 reference statements)

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“…Primary extragonadal non-gestational mediastinal choriocarcinoma is a highly aggressive tumour primarily seen in young men associated with a poor prognosis 1–4 8–12. Patients with primary mediastinal germ cell tumours fare worse than those with tumours at other locations 1 8 9 11 13–17. Malignant germ cell tumours emerge from a totipotent cell; thus, accounting for the wide variety of primary anatomic sites, including gonadal, sacrococcygeal, mediastinal, retroperitoneal and other paraxial locations 18.…”

Section: Discussionmentioning

confidence: 99%

Primary non-gestational mediastinal choriocarcinoma metastatic to the brainstem

et al. 2022

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Choriocarcinoma is a highly malignant tumour emerging from the syncytiotrophoblast divided into gestational and non-gestational presentations. Primary choriocarcinoma of the mediastinum is rare. Metastases to the brain often occur; however, brainstem involvement has not been reported for non-gestational choriocarcinoma. We described a middle-aged man who developed a complete left oculomotor nerve paralysis secondary to a brainstem tumour at the midbrain. The workup for the primary source of the brainstem tumour included a chest CT scan, which revealed a mediastinal mass. A mediastinal mass needle biopsy confirmed the diagnosis of primary mediastinal choriocarcinoma. Despite aggressive chemotherapy, the patient died 6 months after the initial presentation from neurological complications and multiorgan failure.

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Section: Discussionmentioning

confidence: 99%

Primary non-gestational mediastinal choriocarcinoma metastatic to the brainstem

et al. 2022

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“…Invariably, male extragonadal ChC demonstrates elevated levels of β-hCG. The histological diagnosis of extragonadal ChC is difficult, often requiring more than one biopsy and consequent delay in diagnosis [33]. If a pertinent panel of immunohistochemistries is performed, specifically including a pancytokeratin and β-hCG, then the diagnosis is more easily reached.…”

Section: Discussionmentioning

confidence: 99%

Extragonadal Non-gestational Choriocarcinoma with Tonsillar Presentation

Payne

Palma

Walker

et al. 2020

Head and Neck Pathol

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Extragonadal non-gestational choriocarcinoma is a rare but well-described phenomenon occurring in patients with midline germ cell tumors. Choriocarcinoma (ChC) is an aggressive neoplasm usually developing in women as a rare complication of pregnancy. In male patients ChC occurs in the testes, usually as a component of mixed germ cell tumors. Very few patients develop extragonadal choriocarcinoma with the tumor occurring in midline locations, such as the mediastinum, retroperitoneum, and central nervous system (mostly pineal gland). Non-midline choriocarcinoma can occur in the lung, gastrointestinal tract, and breast, sometimes blended with another primary malignancy. A midline choriocarcinoma manifesting as a head and neck malignancy is exceptional. During an evaluation of multiple enlarged cervical lymph nodes suspected to be lymphoma in a 72-year-old man, a core biopsy was taken from one of the left neck lymph nodes which histologically showed a necrotic malignancy with strong diffuse pancytokeratin staining. After an initial interpretation of metastatic carcinoma, further samples were taken from both tonsils and from a right level 5 neck lymph node. Histologically, all samples contained the same tumor, showing profound pleomorphism and multinucleated syncytial-type giant cells. A panel of immunohistochemistry studies were performed, including β-human chorionic gonadotropin, with positive findings leading to a diagnosis of extragonadal non-gestational choriocarcinoma.

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“…PCC has been reported in the central nervous system, pineal body and suprasellar regions, mediastinum, retroperitoneum, lung and liver. Additionally, although PCC is very rare in males, the primary mediastinal choriocarcinoma variant is almost exclusively seen in young males [4,5]. Those with primary mediastinal choriocarcinoma have symptoms that are non-specific and share features seen in metastatic disease which makes the diagnosis difficult.…”

Section: Introductionmentioning

confidence: 99%

“…Those with primary mediastinal choriocarcinoma have symptoms that are non-specific and share features seen in metastatic disease which makes the diagnosis difficult. Most commonly, symptoms reported include cough, dyspnea, hemoptysis, and chest pain [4,6]. Like other choriocarcinoma subtypes, elevated serum beta-human chorionic gonadotropin (hCG) levels as well as trophoblastic cells on histologic examination support the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Choriocarcinoma Presenting as a Pleural Effusion

Hamera¹,

Posch²,

Abraham³

et al. 2020

Cureus

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Choriocarcinoma is a germ cell tumor characterized by widespread metastases and poorly differentiated cells. Non-gestational choriocarcinoma, or primary choriocarcinoma is a trophoblastic disease which is associated with a poor patient prognosis and is markedly angioinvasive. Primary non-gestational mediastinal choriocarcinoma is a very rare disease and represents an aggressive malignancy, primarily seen in young males. Those with primary mediastinal choriocarcinoma have symptoms that are non-specific such as cough, dyspnea, hemoptysis, and chest pain. Here we present the case of a 47-year-old Caucasian female who presented with worsening dyspnea and cough. Laboratory testing revealed elevated alkaline phosphatase, human chorionic gonadotropin, and cancer antigen 125. Chest X-ray was significant for a large right pleural effusion and a computed tomography angiogram of the chest showed a soft tissue mass in the anterior medial right lung base/right middle lobe. Thoracentesis yielded results consistent with malignant cells favoring a germ cell tumor. Biopsy of the mediastinal mass revealed positivity for inhibin and both human chorionic gonadotropin and CD-10 which led to the diagnosis of primary choriocarcinoma. Primary mediastinal choriocarcinoma is uncommon and often has a non-specific clinical presentation. A high degree of suspicion is needed as this malignancy can be aggressive, necessitating urgent definitive tissue biopsy diagnosis to guide appropriate therapy.

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Male primary mediastinal choriocarcinoma with diffuse metastases

Cited by 16 publications

References 20 publications

Primary non-gestational mediastinal choriocarcinoma metastatic to the brainstem

Primary non-gestational mediastinal choriocarcinoma metastatic to the brainstem

Extragonadal Non-gestational Choriocarcinoma with Tonsillar Presentation

Choriocarcinoma Presenting as a Pleural Effusion

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