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choriocarcinoma with lumbar muscle metastases:A case report

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World Journal of Clinical Cases 2020年第20期8卷 5036-5041页

作者： Li Pang Xiao-Xin Ma Department of Obstetrics and Gynecology Shengjing Hospital Affiliated to China Medical UniversityShenyang 110004Liaoning ProvinceChina

BACKGROUND choriocarcinoma is a highly malignant trophoblastic tumor that presents with early symptoms similar to those of an ectopic pregnancy.Here we present a patient with suspected ectopic pregnancy diagnosed by laparoscopic surgery in our hospital.The patient was found to have choriocarcinoma that had metastasized to the lumbar muscle and presented with symptoms similar to those of an ectopic pregnancy.CASE SUMMARY The patient was a 34-year-old female who complained of amenorrhea lasting 53 d,7 d of right lower back pain,and 3 d of right lower abdominal pain.Transvaginal ultrasonography revealed the absence of a gestational sac in the uterus and a mass in the left adnexa.After 6 d of re-examination,ultrasound and computed tomography(CT)examination were performed on the mass located in the left adnexa area.We also noted that the patient's serumβ-human chorionic gonadotropin(h CG)level was increased.Considering an ectopic pregnancy,we performed a laparoscopy and hysteroscopy.During the operation,a left ovarian mixed echogenic mass approximately 2.5 cm×2.0 cm with no villous tissue was found.Postoperative levels of serum h CG continued to increase.Lung CT examination showed lung nodules.Both CT and magnetic resonance imaging showed a mixed echogenic mass in the lumbar muscle.Considering lumbar metastasis of choriocarcinoma,six courses of cisplatin,dactinomycin,and etoposide chemotherapy were given after surgery.The patient's serumβ-h CG level decreased to normal and the mixed echogenic mass in the lumbar muscle decreased in size after the fifth course of chemotherapy.All symptoms subsequently disappeared after treatment.CONCLUSION In summary,lumbar metastasis from choriocarcinoma is extremely rare.Appropriate chemotherapy can successfully treat these metastasized tumors.

关键词： choriocarcinoma Ectopic pregnancy Lumbar Malignant trophoblastic tumor Metastasis Human chorionic gonadotropin Case report

choriocarcinoma-associated pulmonary thromboembolism and pulmonary hypertension： a case report

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The Journal of Biomedical Research 2016年第3期30卷 243-247页

作者： Yan Zhu Meining Yu Luyao Ma Hai Xu Fanghong Rose Li Departments of Pathology The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Cardiothoracic Surgery The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Diagnostic Radiology The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China

Cases of pulmonary embolism and pulmonary artery hypertension caused by choriocarcinoma represent a rare clinical emergency. We report a case of a 25-year-old woman who presented with pulmonary embolism and hyper- tension and died soon after complete pulmonary embolectomy. A related literature review revealed that almost all of these patients had previously experienced a spontaneous abortion （average, 6 months） and were not pregnant.

关键词： choriocarcinoma pulmonary embolism pulmonary artery hypertension pulmonary thromboembolism,fl-hCG

choriocarcinoma misdiagnosed as cerebral hemangioma:A case report

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World Journal of Clinical Cases 2021年第30期9卷 9174-9181页

作者： Hui-Qiong Huang Feng-Ming Gong Ru-Tie Yin Xiao-Juan Lin Gynecological Oncology of Biotherapy Laboratory Department of Gynecology and ObstetricsKey Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University)Ministry of EducationWest China Second University HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND choriocarcinoma is a subtype of gestational trophoblastic disease,gestational trophoblastic neoplasia.Patients with brain metastasis are rare and information on the optimal treatment and patient outcome is limited.In order to improve the prognosis of this disease,accurate and timely treatments are very important for the patient of brain metastasis by choriocarcinoma.CASE SUMMARY A 17-year-old unmarried girl was misdiagnosed with a cerebral hemangioma with intracranial hemorrhage in a local hospital after presentation with severe head pain.She underwent craniotomy three times for treatment.The pathological results of posterior intracranial hematoma showed choriocarcinoma,and the patient was diagnosed as choriocarcinoma(21 points in stage IV).After uterine artery embolization,etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine chemotherapy for 7 cycles,and whole brain radiotherapy,the patient achieved remission.She has been followed for 2 years with no signs of tumor recurrence.CONCLUSION For female patients of childbearing age with an intracranial hematoma,the possibility of brain metastasis by choriocarcinoma should be considered.It is necessary to obtain a detailed history,including menstruation,beginning age of first sex,contraception,etc.The level ofβ-human chorionic gonadotropin should be tested at the beginning,and a stratified treatment should be administered according to the International Federation of Gynecology and Obstetrics staging and World Health Organization prognostic scoring systems.

关键词： Brain metastasis choriocarcinoma Uterine artery embolization Chemotherapy Whole brain radiotherapy Craniotomy Case report

Treatment of respiratory failure in metastatic pulmonary choriocarcinoma： an experience at Peking Union Medical College Hospital, China

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Chinese Medical Journal 2012年第7期125卷 1214-1218页

作者： SHEN Yun REN Tong FENG Feng-zhi WAN Xi-run XIANG Yang Department of Obstetrics and Gynecology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Background Respiratory failure caused by metastatic pulmonary choriocarcinoma usually develops rapidly and is associated with a high mortality. The clinical management strategy is important in choriocarcinoma patients with acute respiratory failure. The objective of this study was to evaluate the clinical characteristics, treatment outcome and potential risk factors in patients with acute respiratory failure from metastatic pulmonary choriocarcinoma. Methods Sixteen patients with acute respiratory failure from pulmonary metastases choriocarcinoma were enrolled and treated at Peking Union Medical College Hospital from 1995 to 2010. Clinical characteristics, causes of pulmonary failure, treatment profiles and outcomes were analyzed retrospectively. Results The presence of respiratory infection or hemorrhage was associated with acute respiratory failure in patients with metastatic choriocarcinoma. Fifteen （93.8%） patients presented with pulmonary infection, 8 （50.0%） patients with pulmonary hemorrhage. All patients were treated with face mask or mechanical ventilation. Fourteen （87.5%） patients received initial chemotherapy at a low dosage or with modified regimens, with a median of 2 cycles （range 1 to 4）. Seven patients achieved a complete remission （CR）, two had a partial remission. Six CR patients remained alive with a median follow-up of 59 months （range 16 to 120）. Seven patients developed progressive diseases and subsequently died. Conclusions Respiratory infection and hemorrhage were associated with acute respiratory failure in metastatic pulmonary choriocarcinoma. The initial administration of gentle chemotherapy regimens, accompanied with mechanical ventilation, is feasible and effective in attenuatina resDiratorv failure in patients with metastatic oulmonarv choriocarcinoma.

关键词： choriocarcinoma chemotherapy pulmonary metastasis respiratory failure mechanical ventilation

Multidisciplinary treatment of life-threatening hemoptysis and paraplegia of choriocarcinoma with pulmonary,hepatic and spinal metastases:A case report

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World Journal of Clinical Cases 2020年第17期8卷 3867-3874页

作者： Yuan-Yuan Lin Yang Sun Yu Jiang Bao-Zhi Song Li-Juan Ke Department of Gynecology Fujian Cancer HospitalAffiliated Cancer Hospital of Fujian Medical UniversityFuzhou 350014Fujian ProvinceChina Department of Gynecology Shengli Clinical Medical College of Fujian Medical UniversityFujian Provincial HospitalFuzhou 350001Fujian ProvinceChina

BACKGROUND Although choriocarcinoma is thought to be a malignancy curable by chemotherapy,there remain difficult and challenging problems in cases with high prognostic scores or extensive metastases,for which the treatment is limited.Particularly,chemotherapy in combination with other treatments offers promising therapeutic potential for these cases.CASE SUMMARY We present the case of a 40-year-old female patient who suffered from lifethreatening hemoptysis and paraplegia due to choriocarcinoma with pulmonary,hepatic and spinal metastases.The patient successfully recovered after multidisciplinary treatment consisting of 21 cycles of intravenous chemotherapy,radiofrequency ablation of multiple hepatic metastases,intensity-modulated radiation therapy for spinal metastases and routine physiotherapy.To our knowledge,it is the first reported case of recovery from pulmonary,hepatic and spinal metastases of choriocarcinoma with no specific primary site.Moreover,this is the first reported clinical attempt on 5-d actinomycin D as primary chemotherapy in ultrahigh-risk gestational trophoblastic neoplasia.CONCLUSION The case supports the opinion that the individualized treatment of choriocarcinoma by a multidisciplinary approach can accomplish optimal therapeutic effects.

关键词： choriocarcinoma Metastases Multidisciplinary treatment Case report Actinomycin D

A Case of Male Primary Pulmonary choriocarcinoma

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Chinese Medical Journal 2018年第24期131卷 3001-3003页

作者： Yuan Ma Chun Wang Pei-Li Sun Yan Zhu Zhen-Kai Huang Shu-Xian Jin Department of Respiratory and Critical Care Medicine The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Respiratory Medicine Nanjing Chest HospitalNanjingJiangsu 210029China Department of Pathology The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Respiratory Medicine Gaoyou Hospital of Traditional Chinese MedicineYangzhouJiangsu 225600China

To the Editor:Extragonadal,nongestational choriocarcinomas are very rare neoplasms that mostly arise spontaneously in midline structures,such as the retroperitoneum,mediastinum,and vicinity of the pineal body,but they also have been reported in other visceral organs,such as the stomach,esophagus,small bowel,prostate, and urinary bladder. In the last seven decades,there have been only 29 cases of male primary pulmonary choriocarcinoma (PPC) reported in the literature.Extragonadal choriocarcinoma arising in the lung is thought to be unresponsive to treatment and is associated with a poor prognosis.We report a 71-year-old male patient with extragonadal,nongestational choriocarcinoma apparently arising in the lung and review the characteristics of previously reported cases to explore the diagnosis and treatment of primary choriocarcinoma of the lung.

关键词： Male Primary Pulmonary choriocarcinoma

Primary gastric choriocarcinoma-a rare and aggressive tumor with multilineage differentiation: A case report

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World Journal of Clinical Cases 2019年第14期7卷 1837-1843页

作者： Simona Gurzu Constantin Copotoiu Alexandra Tugui Cedric Kwizera Rita Szodorai Ioan Jung Department of Pathology University of MedicinePharmacySciences and TechnologyTargu Mures 530149Romania Research Center (CCAMF) University of MedicinePharmacySciences and TechnologyTargu Mures 540139Romania Department of Surgery University of MedicinePharmacySciences and TechnologyTargu Mures 530149Romania

BACKGROUND Primary choriocarcinoma of the stomach (PCCS) is a rare tumor, with fewer than 60 cases published in the English-language literature up to December 2018. In this paper, we present the complex immunoprofile of one PCCS and a hypothesis regarding its histogenesis. CASE SUMMARY A 66-year-old previously healthy male underwent an emergency palliative gastrectomy for a gastric obstructive tumor. The histologic examination and immunoprofile of tumor cells showed a mixed tumor that consisted of choriocarcinoma (90%) and moderate differentiated adenocarcinoma (10%), with hepatic metastases (Stage pT2NxM1L1V1R0) and microsatelite stable status. The patient died one month after surgery. The tumor cells showed focal positivity for CDX2 (adenocarcinoma component), HCG (choriocarcinoma) and CD138 (plasmacytoid carcinoma component) and were negative for HER-2,α- fetoprotein, VEGF, maspin and markers of epithelial-mesenchymal transition. The gastric mucosa cells displayed positivity for CDX2, Hepar A and CD138. The complex immunoprofile and literature data synthesis prove that the gastric mucosa cells can present a multilineage differentiation. CONCLUSION PCCS should be considered as an aggressive variant of microsatellite stable gastric adenocarcinoma of an epithelial type, and not a germ cell tumor.

关键词： choriocarcinoma Stomach Gastrointestinal Immunohistochemistry Maspin Case report

Tuberculosis Infected T Lymphocyte Spot as a Differential Diagnosis of Pulmonary Tuberculosis and choriocarcinoma Recurrence: A Case Report and Review of the Literature

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Journal of Biosciences and Medicines 2023年第9期11卷 31-36页

作者： Qi Wu Zhaoping Chu Jun Dai Ligang Jia Xinling Wang Lihui Li Jie Li Yuan Zhang Ping Yan Jianxiang Hou Department of Gynaecology Hebei General Hospital Shijiazhuang China Department of Immunology and Pathobiology Hebei University of Chinese Medicine Shijiazhuang China Department of Gynaecology The Fourth Hospital of Shijiazhuang Shijiazhuang China

Introduction: choriocarcinoma is an aggressive tumor, whose incidence is 0.18 per 100,000 women between the ages of 15 and 49 years [1]. Although its prognosis has improved with the development of chemotherapy regimens, the mortality rate of patients with brain metastases is reportedly 29.7% [2]. After chemotherapy, most often, the reappearance of masses in pulmonary is considered to be a sign of relapse. Case presentation: The patient was a 32-year-old Asian Chinese female who delivered a dead male infant at 33 weeks gestation. The placenta appeared to be normal. The major presentation was a haemorrhage of the vagina. The patient received combined treatment with systematic multi-agent chemotherapy and whole-brain radiation therapy at the General Hospital of Hebei Province and achieved complete remission. Two years after remission, a chest CT scan revealed a mass in the right lung that had become larger over 6 months. The patient’s serum β-human chorionic gonadotropin (β-HCG) level was normal, and the tuberculosis infected T lymphocyte spot (T-SPOT.TB) tests were positive. The patient was started on anti-tuberculosis therapy, after which the size of her right lung mass decreased. Conclusion: Lung masses after choriocarcinoma require extensive laboratory and imaging exams to exclude recurrence. This case highlights the importance of differential diagnoses of lung masses in patients with choriocarcinomas. Imaging studies, β-HCG and local lesion resection should be employed to rule out choriocarcinoma recurrence.

关键词： choriocarcinoma Tuberculosis

Rapid Evolution of a Case of choriocarcinoma Following Normal Delivery at Term Pregnancy

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1215-1218页

作者： Nafiou Idi Mahamadou Garba Hannatou Sanoussi Rahmatou Madeleine Garba Madi Nayama Niamey Niger

We report a case of postpartum choriocarcinoma with rapid evolution. The patient died 6 months after diagnosis. We underline the interest of the systematic histological examination of any pregnancy tissue, particulary... 详细信息

关键词： choriocarcinoma Postpartum Prognosis Niamey