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Hu T, Wu Q, Li J, Li T, Xu J, Zhou L. Tislelizumab for treatment of a pediatric patient with primary mediastinal choriocarcinoma: a case report. Transl Pediatr 2024; 13:1496-1502. [PMID: 39263302 PMCID: PMC11384437 DOI: 10.21037/tp-24-124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/27/2024] [Indexed: 09/13/2024] Open
Abstract
Background Primary mediastinal choriocarcinoma (PCC) is a rare, highly vascular invasive, and prognostically unfavorable malignant tumor. When occurring outside the gonads, primary choriocarcinoma is commonly found in midline locations such as the mediastinum or retroperitoneum. Currently, there is no standardized treatment strategy for PCC. In the case reported herein, we employed tislelizumab and chemotherapy in the treatment of a patient with PCC, and as in March 2024, the patient remained survive. Case Description A 15-year-old boy who presented with symptoms of fever and cough for a year. Chest computed tomography (CT) scan showed a relatively large soft tissue shadow in the right upper anterior mediastinum, measuring approximately 5.4 cm × 3.8 cm. The patient's soft tissue exhibited unclear demarcation from surrounding mediastinal structures and was accompanied by lung metastasis. The patient underwent a fine needle aspiration biopsy for a mediastinal mass, and the pathology results indicated a germ cell tumor with solid malignant components in the mediastinum, along with pulmonary metastasis of the solid malignancy. The patient's serum levels of beta-human chorionic gonadotropin (β-HCG) were elevated at 125,554 mIU/mL (normal range: <5 mIU/mL), and alpha-fetoprotein (AFP) was 75.8 ng/mL (normal range, 0.605-7 ng/mL). The patient's cranial magnetic resonance imaging (MRI) plain scan indicated multiple scattered abnormal signals in both cerebral hemispheres. Subsequently, the patient was transferred to Children's Hospital of Nanjing Medical University for his further treatment. During the treatment period, we employed various therapeutic approaches, including chemotherapy, radiotherapy and tislelizumab therapy. After five cycles of tislelizumab treatment, the patient's symptoms of cerebral edema significantly improved, β-HCG levels decreased. Brain MRI of the patient revealed multiple abnormal signals within the skull, with some lesions showing reduction in size and significant improvement in the surrounding edema zones. The clinical symptoms of the patient improved and he achieved partial remission (PR). At the moment, the patient is living with the disease. Conclusions The effectiveness of chemotherapy for PCC is limited. Tislelizumab may potentially serve as salvage treatment options for PCC.
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Affiliation(s)
- Tianjiao Hu
- Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qizi Wu
- Department of Hematology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jian Li
- Department of Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Li
- Department of Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jin Xu
- Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhou
- Department of Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China
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Tseng JJ, Chen CY, Liang CW, Huang FL. Pediatric primary extragonadal choriocarcinoma - A study on male patients at a single tertiary medical institution. Pediatr Neonatol 2024:S1875-9572(24)00097-4. [PMID: 39054236 DOI: 10.1016/j.pedneo.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/31/2023] [Accepted: 03/12/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Primary extragonadal choriocarcinoma (PEGCC) in male is rare. It is highly malignant, typically presents with distant metastasis at the time of diagnosis, and responds poorly to treatment. Because of its associated high levels of PD-L1, the PD-1/PD-L1 pathway is a likely therapeutic target. Herein, we report our experience of treating pediatric PEGCC in six boys at a tertiary hospital. METHODS We analyzed the data of six boys with pathologically confirmed PEGCC between 2009 and 2021. Their clinicodemographic and histopathological characteristics as well as treatments and clinical outcomes were retrieved from their medical charts. RESULTS The patients' median age was 15 (range: 12-17) years. The most common primary tumor site was the mediastinum (67%, 4/6), with one case each in the retroperitoneum (16.7%) and brain (16.7%). Except for the patient with brain PEGCC, all presented with metastasis at the time of diagnosis. The following metastatic sites were observed: the lungs (100%, 5/5), brain (3/5, 60%), liver (3/5, 60%), kidneys (2/5, 40%), and spleen (1/5, 20%). Most patients had dry cough, dyspnea, and hemoptysis at initial presentation, likely due to lung metastasis. Serum human chorionic gonadotropin (HCG) levels were highly elevated in all patients. All patients received platinum-based cytotoxic chemotherapy. The patient with brain choriocarcinoma underwent surgical tumor resection; all others underwent only surgical biopsy. Strong positive PD-L1 immunohistochemical staining was noted for two patients. One patient received the PD-L1 inhibitor pembrolizumab and achieved a good response. Our cohort's 1-year survival rate was 33.3%, with a median survival of 4.34 months. Serum HCG levels remained normal in the two survivors during follow-up visits. CONCLUSION The poor response to current platinum-based chemotherapy remains a major challenge in the management of pediatric PEGCC. Adding pembrolizumab to a conventional chemotherapy regimen may improve the outcomes in boys with PEGCC.
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Affiliation(s)
- Jui-Ju Tseng
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan
| | - Chi-Yen Chen
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chiung-Wen Liang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Fang-Liang Huang
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan; Hung Kuang University, Taichung, Taiwan; Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan.
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Mangla M, Palo S, Kanikaram P, Kaur H. Non-gestational choriocarcinoma: unraveling the similarities and distinctions from its gestational counterpart. Int J Gynecol Cancer 2024; 34:926-934. [PMID: 38123189 DOI: 10.1136/ijgc-2023-004906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Choriocarcinoma is a highly vascular and invasive tumor of anaplastic trophoblast, predominantly made up of cytotrophoblasts and syncytiotrophoblasts without villi. Based on its origin, choriocarcinoma can be either gestational or non-gestational. Non-gestational choriocarcinoma can be of germ cell origin, or can be seen in association with a somatic high-grade malignancy. It is difficult to differentiate gestational from non-gestational choriocarcinoma, especially in the reproductive age group. It is important to distinguish between the two, for accurate staging and prognostication, deciding the primary treatment modality, (ie, surgery or chemotherapy), and tailoring follow-up timeframes after diagnosis. An extensive literature search was performed regarding all cases of non-gestational choriocarcinoma, published before March 2023. A note was made of whether the origin of choriocarcinoma was ascertained and how gestational choriocarcinoma was differentiated from non-gestational choriocarcinoma. The keywords used for literature search were "non-gestational choriocarcinoma", "primary choriocarcinoma", "ovarian choriocarcinoma", "ovarian germ cell tumors", or "choriocarcinomatous differentiation". This review aims to summarize the similarities and differences in the epidemiology, pathogenesis, clinical presentation, and management guidelines between gestational and non-gestational choriocarcinoma, which can form an important educational resource for clinicians and laboratory physicians dealing with such cases.
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Affiliation(s)
- Mishu Mangla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences - Bibinagar, Hyderabad, Telangana, India
| | - Seetu Palo
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences - Bibinagar, Hyderabad, Telangana, India
| | - Poojitha Kanikaram
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences - Bibinagar, Hyderabad, Telangana, India
| | - Harpreet Kaur
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences - Bilaspur, Bilaspur, Himachal Pradesh, India
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Pakkala AK, Nekarakanti PK, Nagari B, Bansal AK, Shroff G, Uppin MS. Primary Hepatic Choriocarcinoma with Pregnancy: A Diagnostic and Therapeutic Challenge. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2023; 81:91-94. [PMID: 36824037 DOI: 10.4166/kjg.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/12/2022] [Accepted: 12/06/2022] [Indexed: 02/25/2023]
Abstract
Choriocarcinoma occurs mainly in the gonads, but an extragonadal origin has been reported, albeit infrequently. Primary hepatic choriocarcinoma (PHC) is a rare malignancy, with only 11 cases reported. Most cases reported were in males, with none reported in pregnant females. A 23-year-old primigravida presented with a large liver lesion involving the right lobe of the liver at 28 weeks of pregnancy. Preoperative imaging was suggestive of hepatocellular carcinoma. She underwent a non-anatomical resection of the liver lesion. Surprisingly, her postoperative histopathology revealed a diagnosis of PHC. Her blood workup showed elevated beta human chorionic gonadotrophin. She underwent a termination of her pregnancy at 32 weeks. Before initiating adjuvant chemotherapy four weeks after surgery, a whole-body PET scan revealed multiple bi-lobar liver and pelvic deposits. After a multidisciplinary team discussion, she was started on adjuvant chemotherapy. She is currently under regular follow-up, seven months post-surgery. PHC, one of the vascular lesions of the liver, poses a diagnostic and therapeutic challenge, warranting a multidisciplinary approach.
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Affiliation(s)
- Amith Kumar Pakkala
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Phani Kumar Nekarakanti
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Bheerappa Nagari
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Ashish Kumar Bansal
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Gourang Shroff
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Megha S Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
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Liu D, Ye Q, Ye M, Yang Y. Primary Anterior Medistinal Choriocarcinoma in Male with Lung Metastasis and Pituitary Microadenoma: A Case Report. Case Rep Oncol 2023; 16:1518-1527. [PMID: 38045429 PMCID: PMC10688996 DOI: 10.1159/000533476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/14/2023] [Indexed: 12/05/2023] Open
Abstract
The authors report a case of a 29-year-old male presented with bilateral breast enlargement with no significant past medical history or estrogen exposure. Serum β-human chorionic gonadotropin (HCG) was 14,306.60 mIU and positron emission tomography-computed tomography discovered a malignant mass on the right side of anterior superior mediastinum. Magnetic resonance imaging demonstrated pituitary microadenoma. Pathological biopsy showed poorly differential pituitary adenoma and immunohistochemical staining displayed that CK(+), PLAP(-), AFP(-), HCG(+), CD30(-), Oct3/4(-), CK7(+), TTF-1(-), CD117(-), Ki 67(80+), CK5/6(-), EMA(partial+), inhibin(partial+). A diagnosis of primary anterior mediastinal choriocarcinoma metastasis to bilateral lungs accompanied with pituitary microadenoma was confirmed. Then the patient received chemotherapy combined with immunotherapy. But serum β-HCG level was still above the normal, and unfortunately, the patient died 6 months after his diagnosis. This case inspires us to think of the possibility of choriocarcinoma when a man presents gynecomastia or lung metastatic symptoms, adding Opdivo to the chemotherapy might not improve the poor treatment outcomes.
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Affiliation(s)
- Dong Liu
- Department of Gynaecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qingjian Ye
- Department of Gynaecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Minjuan Ye
- Department of Gynaecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuebo Yang
- Department of Gynaecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Aguiar Bujanda D, Pérez Cabrera D, Croissier Sánchez L. Extragonadal Germ Cell Tumors of the Mediastinum and Retroperitoneum: A Surveillance, Epidemiology, and End Results-based Study. Am J Clin Oncol 2022; 45:493-500. [PMID: 36394133 DOI: 10.1097/coc.0000000000000959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Extragonadal germ cell tumors (EGCT) are a rare entity, most of them being located in the mediastinum and retroperitoneum. Information on these tumors is scarce, requiring carrying out large population-based studies to better understand these diseases. We aimed to determine the clinical features and prognosis of patients with EGCT of the mediastinum and retroperitoneum. MATERIALS AND METHODS Demographic and clinicopathological features of patients diagnosed with EGCT of the mediastinum and retroperitoneum from 1975 to 2016 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS A total of 1674 patients were included, 1297 (77.5%) of mediastinal origin and 377 (22.5%) of retroperitoneum. Nonseminomatous tumors (56.3%) were slightly more frequent than seminomas (43.7%) with similar distribution between mediastinum and retroperitoneum. After a median follow-up of 137 months, the median overall survival was 263 months (95% CI, 220-296) whereas the median cause-specific survival (CSS) has still not been reached. The 10-year overall survival and CSS were 57.4% (95% CI, 55-59.7) and 63% (95% CI, 60.6-65.2) respectively. Multivariate analysis showed that older age, mediastinal location, nonseminomatous histology, and distant disease at diagnosis were independent prognostic factors correlated with a worse prognosis. Patients with mediastinal choriocarcinoma and embryonal carcinoma have the worst prognosis, both with a median CSS of only 12 months. CONCLUSIONS Despite a decreasing incidence observed in recent decades, EGCT continues to represent a challenge for oncologists. The prognosis of choriocarcinoma and embryonal carcinoma of the mediastinum remains poor and treatment strategies need to be improved urgently.
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Affiliation(s)
- David Aguiar Bujanda
- Department of Medical Oncology, Doctor Negrín University Hospital of Gran Canaria Las Palmas de Gran Canaria, Spain
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Koilpillai S, Sun TY, Kropf J, Madruga M, Mohammed SY, Carlan SJ. A 24-Year-Old Man Presenting with Lung Metastases from a Primary Retroperitoneal Extragonadal Choriocarcinoma. AMERICAN JOURNAL OF CASE REPORTS 2022; 23:e936288. [PMID: 35927927 PMCID: PMC9361777 DOI: 10.12659/ajcr.936288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/24/2022] [Accepted: 06/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Primary retroperitoneal choriocarcinoma is a rare form of extragonadal germ cell tumor that is highly aggressive and responds poorly to chemoradiation. Extragonadal choriocarcinomas are notoriously challenging to diagnose, and have often progressed to advanced disease by the time of diagnosis. The survival rate for extragonadal choriocarcinoma is approximately 30%, which is much lower than that of extragonadal non-seminomatous germ cell tumors (GCT) in general. CASE REPORT A 24-year-old man with no significant past medical history presented with left-sided, pleuritic chest pain and back pain radiating down his left leg, of 1-year duration. Computed tomography (CT) of the chest revealed multiple bilateral pulmonary nodules and a CT of the abdomen and pelvis showed a large heterogeneous soft tissue mass measuring 9.3×8×10.5 cm. A CT-guided core needle biopsy of a lung nodule was performed and the findings were consistent with the diagnosis of metastatic choriocarcinoma. Magnetic resonance imaging (MRI) of the brain was negative for metastatic disease. Tumor markers were significant for a markedly elevated beta human chorionic gonadotropin (B-hCG) of 104 712 mIU/mL. He was diagnosed with a stage IIIC germ cell tumor, further classified as a primary retroperitoneal choriocarcinoma with lung metastasis, and was started on urgent inpatient chemotherapy. CONCLUSIONS Due to the poor outcomes associated with extragonadal choriocarcinoma, it is important to promptly and correctly identify this malignancy in order to initiate treatment in a timely manner. The following case report explores the histopathologic characterization of this malignancy and describes the clinical course and outcomes from treatment for this patient.
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Affiliation(s)
- Sarina Koilpillai
- Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA
| | - Thomas Y. Sun
- Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA
| | - Jacqueline Kropf
- Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA
| | - Mario Madruga
- Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA
| | | | - Steven J. Carlan
- Division of Academic Affairs and Research, Orlando Regional Healthcare, Orlando, FL, USA
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Mnikhovich MV, Ovakimian TR, Romanov AV, Bezuglova TV, Snegur SV, Pavlova YG, Kokoreva AY. [Primary choriocarcinoma of the liver in a 36-year-old male patient. A case report and literature review]. Arkh Patol 2022; 84:56-60. [PMID: 36469719 DOI: 10.17116/patol20228406156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The article presents a case of primary liver choriocarcinoma in a 36-year-old man. The patient was admitted to the hospital with signs of rapidly developing multiple organ failure, in connection with which the diagnosis was verified at autopsy according to histological and immunohistochemical studies. Diagnostic criteria and treatment options for this disease are insufficiently developed due to its rarity. To date, 11 clinical cases of primary choriocarcinoma of the liver in males have been described in the international literature. The article presents a review of the literature, as well as describes all published clinical observations of the disease.
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Affiliation(s)
- M V Mnikhovich
- Avtsyn Research Institute of Human Morphology of Federal state budgetary scientific institution «Petrovsky National Research Centre of Surgery», Moscow, Russia
| | - T R Ovakimian
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A V Romanov
- Avtsyn Research Institute of Human Morphology of Federal state budgetary scientific institution «Petrovsky National Research Centre of Surgery», Moscow, Russia
| | - T V Bezuglova
- Avtsyn Research Institute of Human Morphology of Federal state budgetary scientific institution «Petrovsky National Research Centre of Surgery», Moscow, Russia
| | - S V Snegur
- Ryazan Regional Clinical Hospital, Ryazan, Russia
| | - Yu G Pavlova
- Ryazan Regional Clinical Hospital, Ryazan, Russia
| | - A Yu Kokoreva
- Pirogov Russian National Research Medical University, Moscow, Russia
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Extragonadal Non-gestational Choriocarcinoma with Tonsillar Presentation. Head Neck Pathol 2020; 15:1047-1053. [PMID: 33128732 PMCID: PMC8384918 DOI: 10.1007/s12105-020-01245-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/22/2020] [Indexed: 12/17/2022]
Abstract
Extragonadal non-gestational choriocarcinoma is a rare but well-described phenomenon occurring in patients with midline germ cell tumors. Choriocarcinoma (ChC) is an aggressive neoplasm usually developing in women as a rare complication of pregnancy. In male patients ChC occurs in the testes, usually as a component of mixed germ cell tumors. Very few patients develop extragonadal choriocarcinoma with the tumor occurring in midline locations, such as the mediastinum, retroperitoneum, and central nervous system (mostly pineal gland). Non-midline choriocarcinoma can occur in the lung, gastrointestinal tract, and breast, sometimes blended with another primary malignancy. A midline choriocarcinoma manifesting as a head and neck malignancy is exceptional. During an evaluation of multiple enlarged cervical lymph nodes suspected to be lymphoma in a 72-year-old man, a core biopsy was taken from one of the left neck lymph nodes which histologically showed a necrotic malignancy with strong diffuse pancytokeratin staining. After an initial interpretation of metastatic carcinoma, further samples were taken from both tonsils and from a right level 5 neck lymph node. Histologically, all samples contained the same tumor, showing profound pleomorphism and multinucleated syncytial-type giant cells. A panel of immunohistochemistry studies were performed, including β-human chorionic gonadotropin, with positive findings leading to a diagnosis of extragonadal non-gestational choriocarcinoma.
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Chen L, Yi X, Zou HL, Chen XA, Gao S, Zhang PH. Coexistence of gastric choriocarcinoma and adenocarcinoma with reproductive hormone secretion in a man: a case report. J Int Med Res 2020; 48:300060520904876. [PMID: 32216498 PMCID: PMC7133413 DOI: 10.1177/0300060520904876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The present study reports a rare case of a 65-year-old male patient with an exophytic ulcerative lesion in the gastric antrum. After performing a radical subtotal gastrectomy with D2 lymph node dissection and Billroth I gastrojejunostomy, histological analysis revealed a poorly differentiated adenocarcinoma combined with a biphasic pattern consisting of cytotrophoblasts and syncytiotrophoblasts. Immunohistochemical analysis showed a positive reaction with an anti-β-human chorionic gonadotropin antibody, and an abnormal increase in reproductive hormones. Furthermore, the patient succumbed to upper gastrointestinal hemorrhage in less than 3 months after the initial diagnosis, although the rupture of his liver metastasis was successfully treated by transhepatic artery embolization during the second admission.
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Affiliation(s)
- Lei Chen
- Department of General Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Xin Yi
- Department of General Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Hong-Li Zou
- Department of Gynaecology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Xu-An Chen
- Department of General Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Shang Gao
- Department of General Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Pei-Hai Zhang
- Department of Gynaecology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
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Shinohara M, Shin T, Daa T, Mimata H. GATA-3 expression in primary pure choriocarcinoma of the bladder. IJU Case Rep 2020; 3:76-78. [PMID: 32743476 PMCID: PMC7292125 DOI: 10.1002/iju5.12151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 01/28/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Primary pure choriocarcinoma of the bladder is extremely rare and should be distinguished from urothelial carcinoma. GATA-3 is a zinc finger transcription factor and a known sensitive immunostaining marker for urothelial carcinoma. However, its accuracy in the detection of urothelial carcinoma is moderate and it is also an important factor in trophoblast differentiation. CASE PRESENTATION A 78-year-old man presented with asymptomatic gross hematuria for 6 months. Cystoscopy and clinical imaging revealed local bladder carcinoma. He underwent a radical cystectomy and histological diagnosis revealed pure choriocarcinoma (pT2aN0M0) with positive immunostaining, indicating GATA-3 was present. Systemic chemotherapy could not be applied due to his poor general condition, and he died 7 months after surgery. CONCLUSION We reported the first case of pure choriocarcinoma of the bladder, which showed positive immunostaining results indicating the presence of GATA-3.
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Affiliation(s)
- Mayuka Shinohara
- Department ofUrologyOita University Faculty of MedicineYufuOitaJapan
| | - Toshitaka Shin
- Department ofUrologyOita University Faculty of MedicineYufuOitaJapan
| | - Tsutomu Daa
- Department ofPathologyOita University Faculty of MedicineYufuOitaJapan
| | - Hiromitsu Mimata
- Department ofUrologyOita University Faculty of MedicineYufuOitaJapan
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Choriocarcinoma of the Bladder: Case Report and Considerations for Diagnosis. Clin Genitourin Cancer 2019; 18:e190-e193. [PMID: 31983623 DOI: 10.1016/j.clgc.2019.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 11/20/2022]
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