Korean J Med.  2015 Dec;89(6):719-722. 10.3904/kjm.2015.89.6.719.

Skeletal Muscle Metastasis and Elevated beta-HCG Level Secondary to Tongue Cancer: a Case Report and Review of Literature

• Ham JS
• Hwang KB
• Hwang S
• Jeong SH
• Lee JY
• Lee SH
• Park K

• KMID: 2268932
• DOI: http://doi.org/10.3904/kjm.2015.89.6.719

Abstract

Metastases to skeletal muscle and paraneoplastic syndromes involving beta-human chorionic gonadotropin (HCG) production are an extremely rare manifestation of head and neck squamous cell carcinoma. We report a patient with a beta-HCG-secreting squamous cell carcinoma of the tongue with diffuse metastases involving skeletal muscle. A 47 year old female, who was being treated heavily with palliative chemotherapy for metastatic tongue cancer, was admitted with a palpable thigh mass and pain. A magnetic resonance image showed an intramuscular metastasis in the thigh. Ultrasound-guided biopsy of the thigh mass confirmed metastatic squamous cell carcinoma. She was scheduled for enrollment into a clinical trial; however, a positive serum beta-HCG test was noticed. There was no evidence of pregnancy or a trophoblastic or non-trophoblastic tumor secreting beta-HCG. Finally, she was revealed to have a paraneoplastic syndrome with diffuse metastases and was ultimately referred for palliative care. We review the literature of previously reported cases of an increase of beta-HCG in patients with head and neck cancer.

Keyword

Tongue neoplasms; Head and neck neoplasms; Chorionic gonadotropin, beta Subunit, Human; Muscle, Skeletal

MeSH Terms

Biopsy
Carcinoma, Squamous Cell
Chorionic Gonadotropin
Chorionic Gonadotropin, beta Subunit, Human
Drug Therapy
Female
Head
Head and Neck Neoplasms
Humans
Muscle, Skeletal*
Neck
Neoplasm Metastasis*
Palliative Care
Paraneoplastic Syndromes
Pregnancy
Thigh
Tongue Neoplasms*
Tongue*
Trophoblasts
Chorionic Gonadotropin
Chorionic Gonadotropin, beta Subunit, Human