Yoshida J, Nagai K, Nishimura M, Takahashi K, Kakinuma R, Nishiwaki Y, Yokose T
Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Jpn J Clin Oncol. 2000 Mar;30(3):163-6. doi: 10.1093/jjco/hyd028.
We describe a rare case of pulmonary squamous cell carcinoma secreting human chorionic gonadotropin (hCG) and its beta-subunit (beta-hCG) in a young female smoker. A 31-year-old mother of one child had been suffering from dysfunctional uterine bleeding for about 1 year. Pelvic examinations and abdominal ultrasonography yielded no abnormal findings and no signs of pregnancy. She developed a pain in the right chest and a huge (12x10 cm) squamous cell carcinoma was diagnosed in the right lower lobe. The serum hCG and beta-hCG levels were high: hCG 5611 mlU/ml (normal upper limit 0.7 mIU/ml), beta-hCG 12 238 mIU/ml (normal upper limit 0.5 mIU/ml). The patient underwent right lower lobectomy and systematic lymph node dissection. Microscopic study showed a poorly differentiated squamous cell carcinoma. The pathological stage was T2N0M0, stage IB. Immunohistochemical staining of the tumor was strongly positive for hCG. The serum hCG level returned to normal 1 month after the operation, while an additional 2 months were necessary for the beta-hCG level to normalize. Dysfunctional uterine bleeding disappeared and the patient is doing well, with no signs of recurrence, 9 months after the resection.
我们描述了一例年轻女性吸烟者中罕见的分泌人绒毛膜促性腺激素(hCG)及其β亚基(β-hCG)的肺鳞状细胞癌病例。一名育有一个孩子的31岁母亲因功能失调性子宫出血约1年。盆腔检查和腹部超声检查未发现异常,也没有怀孕迹象。她出现右胸痛,经诊断右下叶有一个巨大(12×10 cm)的鳞状细胞癌。血清hCG和β-hCG水平很高:hCG为5611 mIU/ml(正常上限0.7 mIU/ml),β-hCG为12238 mIU/ml(正常上限0.5 mIU/ml)。患者接受了右下叶切除术和系统性淋巴结清扫术。显微镜检查显示为低分化鳞状细胞癌。病理分期为T2N0M0,ⅠB期。肿瘤的免疫组化染色显示hCG呈强阳性。术后1个月血清hCG水平恢复正常,而β-hCG水平恢复正常则需要额外2个月。功能失调性子宫出血消失,切除术后9个月患者情况良好,无复发迹象。