Widespread choriocarcinoma metastases from de-differentiated gastro-esophageal junction primary adenocarcinoma: A case report with literature review

Schrader, Evan; Stephens, Amanda J.; Shroff, Seema; Ahmad, Sarfraz; Holloway, Robert W.

doi:10.1016/j.gore.2019.100513

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…Those with solely choriocarcinoma components have been treated with methotrexate regimens [6]. Moreover, treatment regimens, such as ours with FOLFOX, have also targeted the adenocarcinoma component of the small bowel tumor [6][7][8]. No human epidermal growth factor receptor 2 (HER-2) positivity was seen in our case, but some reports of HER-2-positive cases to date have shown a positive adenocarcinoma or choriocarcinoma component response with trastuzumab combined with docetaxel and carboplatin [4].…”

Section: Discussionmentioning

confidence: 75%

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Jaundice and Elevated Beta-Human Chorionic Gonadotropin in a Female: Duodenal Choriocarcinoma, Not Pregnancy

Berry

2020

Cureus

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A 29-year-old woman with developmental delay presented with 2.5 weeks of jaundice of the skin with accompanying microcytic anemia (hemoglobin 6.8 g/dL, mean corpuscular volume 70.5 fL), elevated liver enzymes (aspartate aminotransferase 77 U/L, alanine aminotransferase 95 U/L, alkaline phosphatase 362 U/L), total bilirubin (9.5 mg/dL; 4.4 mg/dL direct), lipase (325 U/L), and cancer antigen 19-9 (68 U/mL). The patient had no prior gastrointestinal or liver disease. CT of the chest/abdomen/pelvis found a large lobulated non-fully obstructing mass in the second and third part of the duodenum, with endoscopic biopsies yielding an invasive, welldifferentiated adenocarcinoma positive for cytoplasmic-stained cells to antibody to betahuman chorionic gonadotropin (hCG) antigen, suggesting a duodenal choriocarcinoma. Treatment included biliary drainage with a percutaneous transhepatic catheter and folinic acid, fluorouracil, and oxaliplatin (FOLFOX) chemotherapy, but a repeat CT scan five months later revealed an increase in tumor size and invasion; the patient died shortly thereafter. Beta-hCGsecreting choriocarcinomas are rare, rapidly growing, highly invasive malignant tumors and are uncommonly present at extragonadal sites.

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Section: Discussionmentioning

confidence: 75%

“…Oftentimes, chemotherapies used for gestational choriocarcinoma are utilized [5]. Those with solely choriocarcinoma components have been treated with methotrexate regimens [6]. Moreover, treatment regimens, such as ours with FOLFOX, have also targeted the adenocarcinoma component of the small bowel tumor [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Jaundice and Elevated Beta-Human Chorionic Gonadotropin in a Female: Duodenal Choriocarcinoma, Not Pregnancy

Berry

2020

Cureus

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“…International Publisher females and males or from carcinoma in situ to metastasis [3]. Patients with choriocarcinoma range from 17 to 67 years old, and the asymptomatic period varies from 4 weeks to 25 years [4].…”

Section: Ivyspringmentioning

confidence: 99%

“…The incidence of choriocarcinoma varies in different regions, ranging from 1 in 15,000-50,000 pregnancies in Europe and North America to 1 in 500-20,000 pregnancies in Southeast Asia 1 , and is >5 in 10,000 pregnancies in China 2 . Although choriocarcinoma is relatively rare, case reports have described it in females and males or from carcinoma in situ to metastasis 3 . Patients with choriocarcinoma range from 17 to 67 years old, and the asymptomatic period varies from 4 weeks to 25 years 4 .…”

Section: Introductionmentioning

confidence: 99%

Reduction of pl-CSA through ChSy-2 knockout inhibits tumorigenesis and metastasis of choriocarcinoma in JEG3 cells

Zhang¹,

Chen²,

Wang³

et al. 2021

Int. J. Med. Sci.

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Background: Placental-like chondroitin sulfate A (pl-CSA) is exclusively expressed in cancerous and placental tissues and is highly correlated with the degree of malignancy. However, the mechanism through which pl-CSA regulates tumorigenesis and metastasis in choriocarcinoma remains unclear. Methods: Stable transfectants of the JEG3 choriocarcinoma cell line, including a negative control (NC) line and a cell line with knockout of the biosynthetic enzyme CS synthase-2 (ChSy-2) (ChSy-2-/-), were obtained using CRISPR/Cas9 systems and identified by immunofluorescence, flow cytometry, western blots and enzyme-linked immunosorbent assays (ELISAs). The proliferation, migration, invasion and colony formation of the cells were determined by a cell counting kit, scratch-wound assays, transwell assays and soft agar colony formation assays in vitro, respectively. The tumorigenesis and metastasis of choriocarcinoma were also investigated through two xenograft models in vivo. Results: The ChSy-2 protein in the ChSy-2-/-group was below the detection threshold, which was accompanied a significant reduction in the pl-CSA level. Reducing pl-CSA through ChSy-2 knockout significantly inhibited cell proliferation, migration, invasion and colony formation in vitro and tumorigenesis and metastasis of choriocarcinoma, with deceases in tumor volume and metastatic foci and a high percent survival compared to the NC in vivo. Conclusion: pl-CSA, as a necessary component of JEG-3 cells, was efficiently reduced through ChSy-2 knockout, which significantly inhibited the tumorigenesis and metastasis of choriocarcinoma. ChSy-2/pl-CSA could be alternative targets for tumor therapy.

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“…Choriocarcinoma (CC), a rare subtype of gestational trophoblastic neoplasia (GTN), tends to metastasize early to distant organs via haematogenous spread and may exhibit peculiar clinical behaviours specific to metastases. 1 , 2 However, spontaneous gingival haemorrhage (SGH) at first presentation is extremely rare and easily misdiagnosed, 3 especially in the absence of detectable gynaecological lesions. It is well known that CC can be divided into gestational (GCC) and nongestational CC (NGC) based on different pathogenetic origins.…”

Section: Introductionmentioning

confidence: 99%

Case Report: First-Line Immune Checkpoint Inhibitor Plus Chemotherapy for Oral Metastasis in a Patient with Ultra High-Risk Gestational Choriocarcinoma

Chen¹,

Yé²,

Tang³

et al. 2022

CMAR

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Choriocarcinoma (CC) tends to metastasize early into various organs and may exhibit peculiar clinical behaviors specific to metastases. Although chemotherapy has revolutionized the survival of most patients, the mortality rate remains high in cases at ultra high-risk, which may be associated with multiple organs involvement and intolerable toxicity resulting from combination chemotherapy. Here, we illustrate a 46-year-old woman patient with oral and lung lesions whose clinical and morphological heterogeneity misled the preliminary diagnosis. According to the initial pathological report of oral squamous cell carcinomas with lung metastasis and a combined positive score = 100, she received first-line immunotherapy plus two-drug chemotherapy, which obtained a surprisingly favourable outcome. Then, CC was identified by a high level of beta human chorionic gonadotropin (β-HCG) in serum and biopsies. DNA polymorphic analysis revealed its gestational origin, and a more aggressive standard regimen was subsequently implemented. However, the patient suffered repeated vomiting and myelosuppression, and the duration of treatment was significantly prolonged. Ultimately, she succumbed to death. The clinical course of this report helps to improve the understanding of this disease. We consider immune checkpoint inhibitors as potential first-line alternatives for ultra-high-risk CC patients, which provide a therapeutic reference for clinicians.

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Widespread choriocarcinoma metastases from de-differentiated gastro-esophageal junction primary adenocarcinoma: A case report with literature review

Cited by 5 publications

References 8 publications

Jaundice and Elevated Beta-Human Chorionic Gonadotropin in a Female: Duodenal Choriocarcinoma, Not Pregnancy

Jaundice and Elevated Beta-Human Chorionic Gonadotropin in a Female: Duodenal Choriocarcinoma, Not Pregnancy

Reduction of pl-CSA through ChSy-2 knockout inhibits tumorigenesis and metastasis of choriocarcinoma in JEG3 cells

Case Report: First-Line Immune Checkpoint Inhibitor Plus Chemotherapy for Oral Metastasis in a Patient with Ultra High-Risk Gestational Choriocarcinoma

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