Vegh Gyorgy L, Szigetvári Ivan, Soltesz Ibolya, Major Katalin, Batorfi Jozsef, Dancso Janos, Zsirai Laszlo, Fulop Vilmos
Department of Obstetrics and Gynecology, National Medical Center, Budapest, Hungary.
J Reprod Med. 2008 May;53(5):369-72.
Primary pulmonary choriocarcinoma (PPC) is an extremely rare clinical entity. In contrast with gestational trophoblastic tumors that show an extreme sensitivity for chemotherapy, extragonadal choriocarcinomas are mostly unresponsive to surgical and chemotherapeutic treatment and are associated with poor prognosis. The reason non-gestational choriocarcinomas behave so differently from gestational tumors is unknown.
In the present case we report a 30-year-old female patient with primary choriocarcinoma of lung localization who was successfully treated with surgical resection and multiple cycles of combination chemotherapy. During her recovery she was followed up by human chorionic gonadotropin (hCG) titer measurement, and after 1 year of close surveillance of beta-hCG levels her disease achieved complete remission.
Because of the extreme rarity of this malignancy, there are no standardized therapeutic guidelines for treatment. The first choice in treatment of PPC is surgical resection. Postoperatively chemotherapy is indicated immediately, because definitive histologic diagnosis is not essential before chemotherapy since beta-hCG is a reliable tumor marker for choriocarcinoma.
原发性肺绒毛膜癌（PPC）是一种极其罕见的临床实体。与对化疗极度敏感的妊娠滋养细胞肿瘤不同，性腺外绒毛膜癌大多对手术和化疗无反应，且预后不良。非妊娠性绒毛膜癌与妊娠性肿瘤表现如此不同的原因尚不清楚。
在本病例中，我们报告了一名30岁的女性原发性肺绒毛膜癌患者，她通过手术切除和多周期联合化疗成功治愈。在她康复期间，通过检测人绒毛膜促性腺激素（hCG）水平进行随访，在对β-hCG水平进行1年的密切监测后，她的疾病实现了完全缓解。
由于这种恶性肿瘤极其罕见，目前尚无标准化的治疗指南。PPC的首选治疗方法是手术切除。术后应立即进行化疗，因为在化疗前无需进行明确的组织学诊断，因为β-hCG是绒毛膜癌可靠的肿瘤标志物。
