When a Differential Diagnosis Is Fundamental: Choriocarcinoma Mimicking Lung Carcinoma

Abstract

Background: Choriocarcinoma is a rare malignant disease that is usually associated with a gestational event. Lung metastasis with no evident primary origin and choriocarcinoma, which mimics features of non-small-cell lung cancer, might be misdiagnosed as adenocarcinoma or large-cell carcinoma. This is a pivotal clinical concern since the tumor can lead to various symptoms, seriously affecting the quality of life and can escalate rapidly, with a high mortality rate, compared to lung cancer. Methods: We reported a case of a 37-year-old woman with a history of one-year enhancement of beta-human chorionic gonadotropin levels and only a single nodule in the right upper lobe, with no abnormal findings on the gynecological investigation. Then we retrospectively examined all cases treated in the Division of Thoracic Surgery at the European Institute of Oncology in the last twenty years (from 1998 to 2018). Results: This was the first time in our experience that choriocarcinoma presentation was with a single nodule without a gynecological finding. Moreover, the differential diagnosis between lung carcinoma and choriocarcinoma was achieved only after surgical removal. Conclusions: As confirmed by our literature search, precise and expedited differential diagnosis is essential in choriocarcinoma care (both with single or multiple metastases), to successfully remove the tumor and increase the patient’s chances of survival.

Importance of Suspecting a Hemorrhagic Intracranial Lesion as Metastatic Choriocarcinoma

“…The clinical presentation depends on the stage of disease but the diagnosis of choriocarcinoma in a patient presenting with symptoms from distant metastasis is challenging. 10 Like in our case when she was admitted multiple times for pneumonia and chest pain discomfort and pulmonary tuberculosis diagnosis made and was on wrong treatment due to misdiagnosis.…”

The 12-year Experience - A Retrospective and Hospital-based Study of Gestational Trophoblastic Neoplasia in the Northwest of China

“…In lung cancer screenings with CT scan, the average nodule detection rate per round in randomized controlled trials and cohort studies ranged from 3-50% [29,30]. Therefore, lung nodules might be misdiagnosed as metastatic lesions with evident invasive mole and choriocarcinoma [31,32]. We, thus, cannot simply conclude that the time has changed features of GTN.…”

Primary pulmonary choriocarcinoma in male: report a case with genetic testing and review of the literature

“…Huang’s research indicated that the expression of GATA-3 may be a tissue-specific marker for trophoblast differentiation, which is of great significance for the diagnosis of choriocarcinoma ( 5 ). Gasparri’s team reported that CK7, AE1/AE3, and CD10 could be positive in pulmonary choriocarcinoma, while TTF-1 and inhibin are negative ( 6 ). Pulmonary choriocarcinoma is rare in clinical practice, easily misdiagnosed, and easily confused with squamous cell carcinoma, giant cell carcinoma, adenocarcinoma, and malignant melanoma.…”