Tuberc Respir Dis.  2006 Dec;61(6):578-584. 10.4046/trd.2006.61.6.578.

A Case of Primary Choriocarcinoma of the Lung

• Cho YJ
• Lee SW
• Lee SM
• Yim JJ
• Yoo CG
• Han SK
• Shim YS
• Kim YW

• KMID: 1970244
• DOI: http://doi.org/10.4046/trd.2006.61.6.578

Abstract

A primary choriocarcinoma of the lung is extremely rare, and difficult to distinguish from a metastatic choriocarcinoma considering that the lung is also one of the most frequent sites of metastasis. We report a 28-year-old woman patient who was initially misdiagnosed with an ectopic pregnancy and was operated on under the impression of an unidentified malignancy of the lung, which was finally proven to be a choriocarcinoma of the lung. A pelvic examination by a gynecologist, pelvic magnetic resonance imaging and whole body fluorodeoxyglucose positron emission tomography-computed tomography was performed in order to rule out a metastatic choriocarcinoma of the lung. After a curative operation, her serum beta-human chorionic gonadotropin (HCG) level, which was highly elevated in the initial evaluation, had decreased dramatically to the normal range. She is currently being followed up regularly without any evidence of recurrence or elevation of her beta-HCG level.

Keyword

Primary choriocarcinoma; Lung; beta-human chorionic gonadotropin (HCG)

MeSH Terms

Adult
Choriocarcinoma*
Chorionic Gonadotropin
Electrons
Female
Gynecological Examination
Humans
Lung*
Magnetic Resonance Imaging
Neoplasm Metastasis
Pregnancy
Pregnancy, Ectopic
Recurrence
Reference Values
Chorionic Gonadotropin

Figure

• 

  Figure 1 Chest radiograph shows an oval shaped-mass in right hilar area(A). Whole body F-18 FDG Fusion PET-CT shows hypermetabolic lesion in right lower lobe area. The maxSUV of lesion is 6.3(B).

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  Figure 2 Chest CT and PET-CT shows a lobulating mass with calcification in the right lower lobe superior segment(A: non-contrast CT, B: contrast-CT, C: lung window setting, D: PET-CT).

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  Figure 3 Gross pathologic image of right lower lobectomy specimen is demonstrating a large intraparenchymal choriocarcinoma(A). Necroses and hemorrhages are showed in the central area of tumor components(B; H&E stain, ×40). Tumor nests are composed of the dimorphic population of malignant cytotrophoblasts and syncytiotrophoblasts(C; H&E stain, ×400).

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  Figure 4 The immunohistochemical staining of the tumor shows positive for β-HCG(A; Immunohistochemical stain, ×200) and negative for TTF-1(B; Immunohistochemical stain, ×200)

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  Figure 5 Ikura's5 hypothetical concept on the conformation of the group of primary pulmonary choriocarcinooma (PCC).

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