Testicular Choriocarcinoma: a Rare Variant that Requires a Unique Treatment Approach

Abstract

Testicular germ cell tumors represent the most common malignancy among young men. While 5-year overall survival and cure for this population is greater than 95%, choriocarcinoma is an aggressive subtype of this disease with far worse prognosis--5-year survival for choriocarcinoma is less than 80%. In order to be able to treat these patients appropriately, a provider must recognize characteristic features of choriocarcinoma including elevated human chorionic gonadotropin in a young man with testicular mass; the astute clinician should also know the signs and symptoms of choriocarcinoma syndrome, characterized by bleeding from metastatic sites, which represents a medical emergency and is associated with high morbidity and mortality. Treatment should be directed towards a goal of tumor marker normalization, and patients with refractory disease should be considered for advanced therapies and clinical trials. Choriocarcinoma is a unique and aggressive germ cell malignancy, and these patients require early aggressive treatment to improve their chance of survival.

RETRACTED ARTICLE: Neferine hinders choriocarcinoma cell proliferation, migration and invasion through repression of long noncoding RNA-CHRF

“…Placental choriocarcinoma possesses incisively sensitive to chemotherapy; therefore, chemotherapy has become the preferred management for remedying placental choriocarcinoma [6]. Nevertheless, testicular choriocarcinoma is highly resistant to chemotherapy, which has the worst prognosis among all germinomas [7]. Hence, exploration of a neoteric method or valid agent for treating choriocarcinoma is still necessary.…”

Rare Case of Spontaneous Tumor Lysis Syndrome (TLS) in a Patient with Germ Cell Tumor (GCT): Literature Review and Approach to Management

“…This patient's clinical presentation with bulky metastatic disease, a markedly elevated serum BHCG, and a testicular mass raised the suspicion for choriocarcinoma syndrome. The patient's shortness of breath and pulmonary metastasis are also common with choriocarcinoma syndrome prompting expedited treatment as these patients are at the highest risk of morbidity and mortality from underlying disease and complications of treatment [20] The addition of bleomycin to cisplatin and etoposide improves outcomes in GCT [19]. Given the acuity of this patient's presentation, his pulmonary tumor burden, as well as multiorgan dysfunction, bleomycin was excluded from the initial cycle of chemotherapy given concern for significant toxicity [21].…”

Head and neck cutaneous metastasis of testicular choriocarcinoma

“…Testicular germ cell tumours (GCT’s) are the cause of 1%–2% of all malignancies in men. They most commonly impact young men, with a roughly 95% 5-year survival rate 1. Testicular choriocarcinoma (CC) whether pure/predominant, is a particularly aggressive variant, characterised by widespread metastasis and often rapid disease progression at time of presentation.…”