Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer
Choriocarcinoma syndrome (CS) is a rare clinical entity within the spectrum of nonseminomatous germ-cell tumors (NSGCT). It is characterized by the abrupt establishment of rapidly progressive and hemorrhagic tumors associated with very high levels of the beta fraction of human chorionic gonadotropin...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/8065615 |
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| author | Carlos Eduardo Salazar-Mejía María Elena García-Gutiérrez María Inés Contreras-Salcido Carlos Javier Rodríguez-Álvarez Blanca Otilia Wimer-Castillo Jackeline Grace Lara-Campos Edio Llerena-Hernández José Luis González-Vela David Hernández-Barajas |
| author_facet | Carlos Eduardo Salazar-Mejía María Elena García-Gutiérrez María Inés Contreras-Salcido Carlos Javier Rodríguez-Álvarez Blanca Otilia Wimer-Castillo Jackeline Grace Lara-Campos Edio Llerena-Hernández José Luis González-Vela David Hernández-Barajas |
| author_sort | Carlos Eduardo Salazar-Mejía |
| collection | DOAJ |
| description | Choriocarcinoma syndrome (CS) is a rare clinical entity within the spectrum of nonseminomatous germ-cell tumors (NSGCT). It is characterized by the abrupt establishment of rapidly progressive and hemorrhagic tumors associated with very high levels of the beta fraction of human chorionic gonadotropin (β-hCG) and with a very poor prognosis, particularly in patients with β-hCG values above 50,000 IU/L. We present the case of a 17-year-old man with a sudden onset nonmassive hemoptysis. Physical examination revealed a right testicular mass. Imaging studies showed metastatic lung, bone, and retroperitoneal disease. β-hCG serum levels were 222,493.21 IU/L, AFP 1.56 ng/mL, and DHL 457 IU/L. Histopathological study after right radical orchiectomy showed a mixed germ-cell tumor. Based on poor-risk characteristics, chemotherapy was started with an adequate clinical response. Physicians should be aware of the potential complications of CS in the treatment of testicular cancer with high β-hCG levels since they could be associated with a rapidly progressive and high-volume disease. Patients in this category should be referred to the centers experienced in the treatment of advanced germ-cell tumors. Due to the severity of the presentation, hemodynamic monitoring, ideally in an intensive care unit, is essential as well as timely administration of cytotoxic treatment. |
| format | Article |
| id | doaj-art-2d5c66963b704dd08763aed397377aa5 |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-2d5c66963b704dd08763aed397377aa52025-02-03T06:13:50ZengWileyCase Reports in Oncological Medicine2090-67062090-67142018-01-01201810.1155/2018/80656158065615Choriocarcinoma Syndrome as an Initial Presentation of Testicular CancerCarlos Eduardo Salazar-Mejía0María Elena García-Gutiérrez1María Inés Contreras-Salcido2Carlos Javier Rodríguez-Álvarez3Blanca Otilia Wimer-Castillo4Jackeline Grace Lara-Campos5Edio Llerena-Hernández6José Luis González-Vela7David Hernández-Barajas8Centro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoCentro Universitario Contra el Cáncer, University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MexicoChoriocarcinoma syndrome (CS) is a rare clinical entity within the spectrum of nonseminomatous germ-cell tumors (NSGCT). It is characterized by the abrupt establishment of rapidly progressive and hemorrhagic tumors associated with very high levels of the beta fraction of human chorionic gonadotropin (β-hCG) and with a very poor prognosis, particularly in patients with β-hCG values above 50,000 IU/L. We present the case of a 17-year-old man with a sudden onset nonmassive hemoptysis. Physical examination revealed a right testicular mass. Imaging studies showed metastatic lung, bone, and retroperitoneal disease. β-hCG serum levels were 222,493.21 IU/L, AFP 1.56 ng/mL, and DHL 457 IU/L. Histopathological study after right radical orchiectomy showed a mixed germ-cell tumor. Based on poor-risk characteristics, chemotherapy was started with an adequate clinical response. Physicians should be aware of the potential complications of CS in the treatment of testicular cancer with high β-hCG levels since they could be associated with a rapidly progressive and high-volume disease. Patients in this category should be referred to the centers experienced in the treatment of advanced germ-cell tumors. Due to the severity of the presentation, hemodynamic monitoring, ideally in an intensive care unit, is essential as well as timely administration of cytotoxic treatment.http://dx.doi.org/10.1155/2018/8065615 |
| spellingShingle | Carlos Eduardo Salazar-Mejía María Elena García-Gutiérrez María Inés Contreras-Salcido Carlos Javier Rodríguez-Álvarez Blanca Otilia Wimer-Castillo Jackeline Grace Lara-Campos Edio Llerena-Hernández José Luis González-Vela David Hernández-Barajas Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer Case Reports in Oncological Medicine |
| title | Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer |
| title_full | Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer |
| title_fullStr | Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer |
| title_full_unstemmed | Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer |
| title_short | Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer |
| title_sort | choriocarcinoma syndrome as an initial presentation of testicular cancer |
| url | http://dx.doi.org/10.1155/2018/8065615 |
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