Primary retroperitoneal choriocarcinoma with lung metastasis: Case report

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Case Report

Author Details : Ruta Gordhanbhai Vekariya*, Shubhada Kanhere

Volume : 11, Issue : 3, Year : 2024

Article Page : 322-325

https://doi.org/10.18231/j.ijpo.2024.070

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Abstract

Extragonadal germ cell tumor with choriocarcinoma in males is a rare tumor. Usually, Choriocarcinoma occurs in the midline of the body, such as the retroperitoneum and mediastinum. The B-hCG is used for diagnosis and monitoring treatment response. It is an aggressive and highly metastatic tumor with poor outcome.
A 24-year-old male patient was admitted in our hospital with abdominal pain that had progressively worsened over two months andwas associated with a weight loss of 7 Kg over 2 months. Patient had no significant medical, personal, and family histories.
The ultrasound abdomen showed mild hepatosplenomegaly and hepatic hemangioma. A CT scan of the thorax and whole abdomen showed multiple bilateral lung lesions with areas of arterial phase hyperenhancement. The largest lesion measured 60 x 42 mm in the left basal lung, and abdominal images showed an 86 x 68 x 90 mm lobulated left para-aortic lesion in the infrarenal location.
An excision of the right lower lobe lung with nodule was done, and the histopathological findings were consistent with those of a germ cell tumor with a component of choriocarcinoma.
Tumor markers, particularly serum beta human chorionic gonadotropin (B-hCG) was significantly raised with level of 917950 mIU/mL. Other tumor markers done were Lactate dehydrogenase (LDH) - 725 U/L and Alpha feto protein (AFP) -0.762 IU/ml.
Patient was diagnosed with a primary retroperitoneal choriocarcinoma with metastasis to lungs and was started on urgent inpatient chemotherapy.
Extragonadal choriocarcinoma always has a late presentation when these bulky tumors cause compression symptoms and metastasize to other places. Diagnosis of extragonadal choriocarcinomas requires the exclusion of metastatsis from a primary tumor in the testes and distinguishing an extragonadal GCT from another poorly differentiated cancer via histopathological and immunohistochemical examination.

Keywords : Extragonadal germ cell tumor, Retroperitoneal choriocarcinoma.

How to cite : Vekariya R G, Kanhere S, Primary retroperitoneal choriocarcinoma with lung metastasis: Case report. Indian J Pathol Oncol 2024;11(3):322-325

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