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Li H, Hu X, Ning MS, Fuller GN, Stewart JM, Gilliam JC, Wu J, Le X, Vaporciyan AA, Lee JJ, Gibbons DL, Heymach JV, Futreal A, Zhang J. Case report: Molecular profiling facilitates the diagnosis of a challenging case of lung cancer with choriocarcinoma features. Front Oncol 2024; 14:1324057. [PMID: 38590653 PMCID: PMC10999639 DOI: 10.3389/fonc.2024.1324057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/29/2024] [Indexed: 04/10/2024] Open
Abstract
Accurate diagnoses are crucial in determining the most effective treatment across different cancers. In challenging cases, morphology-based traditional pathology methods have important limitations, while molecular profiling can provide valuable information to guide clinical decisions. We present a 35-year female with lung cancer with choriocarcinoma features. Her disease involved the right lower lung, brain, and thoracic lymph nodes. The pathology from brain metastasis was reported as "metastatic choriocarcinoma" (a germ cell tumor) by local pathologists. She initiated carboplatin and etoposide, a regimen for choriocarcinoma. Subsequently, her case was assessed by pathologists from an academic cancer center, who gave the diagnosis of "adenocarcinoma with aberrant expression of β-hCG" and finally pathologists at our hospital, who gave the diagnosis of "poorly differentiated carcinoma with choriocarcinoma features". Genomic profiling detected a KRAS G13R mutation and transcriptomics profiling was suggestive of lung origin. The patient was treated with carboplatin/paclitaxel/ipilimumab/nivolumab followed by consolidation radiation therapy. She had no evidence of progression to date, 16 months after the initial presentation. The molecular profiling could facilitate diagnosing of challenging cancer cases. In addition, chemoimmunotherapy and local consolidation radiation therapy may provide promising therapeutic options for patients with lung cancer exhibiting choriocarcinoma features.
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Affiliation(s)
- Hui Li
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Xin Hu
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Matthew S. Ning
- Department of Thoracic Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gregory N. Fuller
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - John M. Stewart
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Jia Wu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ara A. Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J. Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Don L. Gibbons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - John V. Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrew Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jianjun Zhang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Wang N, Zhang N, Zhang X, Wang Y, Fu Y, Guo L, Liang C, Yu M. The tumor or inflammation? a case report on primary pulmonary choriocarcinoma. Front Oncol 2023; 13:1108798. [PMID: 37519783 PMCID: PMC10372341 DOI: 10.3389/fonc.2023.1108798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Choriocarcinoma is a rare malignant germ cell neoplasm with high invasiveness, the majority of which are pregnancy-related, and the female genital tract is the most prevalent site of the disease. Although early-stage choriocarcinoma typically metastasizes to the lungs, primary pulmonary choriocarcinoma is extremely rare. Primary pulmonary choriocarcinoma is difficult to diagnose, and it progresses rapidly. Combined with the difficulty of treatment, the prognosis of patients is generally poor. In this article, we retrospectively analyzed a case of female primary pulmonary choriocarcinoma, combined with a review of literature, to understand and describe the diagnostic and treatment progress of PPC.
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Affiliation(s)
- Na Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Nan Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinyue Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuanyuan Wang
- Department of Medical Imaging, Binzhou Medical University, Yantai, Shandong, China
| | - Yajie Fu
- Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging, Jinan, Shandong, China
| | - Lingfei Guo
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Changhu Liang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Mengru Yu
- Shandong Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Iwasaki K, Watanabe K, Kimura H, Yano S. Utility of beta-human chorionic gonadotropin in pleural effusions: Report of an autopsy case of a male patient with primary pulmonary choriocarcinoma. Clin Case Rep 2022; 10:e6663. [PMID: 36483884 PMCID: PMC9723396 DOI: 10.1002/ccr3.6663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/25/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022] Open
Abstract
A 69-year-old male patient presented with bloody pleural fluid effusion and elevated beta-human chorionic gonadotropin (β-hCG) levels obtained by thoracentesis. The patient's condition rapidly deteriorated, and he died. The autopsy revealed primary pulmonary choriocarcinoma. Early diagnosis of choriocarcinoma based on β-hCG levels in the pleural fluid may be possible.
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Affiliation(s)
- Kazuhiko Iwasaki
- Department of Respiratory medicineJapan Community Health Care Organization Kanazawa HospitalKanazawaJapan,Department of Respiratory medicineKanazawa Graduate school of Medical SciencesKanazawaJapan
| | - Kazuyoshi Watanabe
- Department of Respiratory medicineJapan Community Health Care Organization Kanazawa HospitalKanazawaJapan
| | - Hideharu Kimura
- Department of Respiratory medicineKanazawa Graduate school of Medical SciencesKanazawaJapan
| | - Seiji Yano
- Department of Respiratory medicineKanazawa Graduate school of Medical SciencesKanazawaJapan
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Dlewati MM, Gonzalez T, Razi SS, Hussain SF, Bennett J. Primary Pulmonary Choriocarcinoma Treated With Neoadjuvant Chemotherapy and Lobectomy: A Case Report. Cureus 2022; 14:e21931. [PMID: 35273872 PMCID: PMC8901110 DOI: 10.7759/cureus.21931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 11/05/2022] Open
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Ben Abdallah I, Mlika M, Berrazega Y, Mejri N, Rachdi H, El Benna H, Daoud N, Laabidi S, Mezni F, Boussen H. Amenorrhea and elevated βhuman chorionic gonadotropin of unknown origin: An unexpected location of choriocarcinoma. Gynecol Oncol Rep 2021; 36:100746. [PMID: 33889701 PMCID: PMC8047451 DOI: 10.1016/j.gore.2021.100746] [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: 01/16/2021] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 10/31/2022] Open
Abstract
Choriocarcinoma is a rare malignancy originating from trophoblastic cells that is known to arise from the placenta. In this report, we describe the case of a 28-year-old female who consulted for amenorrhea and elevated βhCG mimicking a pregnancy of an unknown location, which ultimately turned out to be primary choriocarcinoma of the lung.
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Affiliation(s)
- Ichrak Ben Abdallah
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
| | - Mona Mlika
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Pathology, Abderrahmane Mami Hospital, Tunisia
| | - Yosra Berrazega
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
| | - Nesrine Mejri
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
| | - Haifa Rachdi
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
| | - Houda El Benna
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Pathology, Abderrahmane Mami Hospital, Tunisia
| | - Nouha Daoud
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
| | - Soumaya Laabidi
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
| | - Faouzi Mezni
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Pathology, Abderrahmane Mami Hospital, Tunisia
| | - Hamouda Boussen
- Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia
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