Department of Urology, Institute of Clinical Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, 1-1-1 Tennodai, Tsukuba, Ibaraki 305, Japan.
Int J Clin Oncol. 2010 Dec;15(6):611-4. doi: 10.1007/s10147-010-0092-3. Epub 2010 Jun 11.
A 40-year-old man was referred to our hospital for treatment of metastatic testicular cancer. Computerized tomography revealed multiple lung, liver, and retroperitoneal lymph node metastases. In addition, magnetic resonance imaging revealed multiple brain metastases. Induction chemotherapy with bleomycin, etoposide, and cisplatin was started the day after a high orchiectomy. The pathological diagnosis of the surgical specimen was yolk sac carcinoma. The serum human chorionic gonadotropin (hCG) was markedly increased to 630,000 mIU/ml, which suggested the presence of a choriocarcinoma element at metastatic sites. The patient subsequently suffered respiratory failure due to pulmonary hemorrhage. Intensive supportive care prevented a fatal outcome. Physicians who treat advanced testicular tumors should be aware of the potential complication of acute pulmonary hemorrhage, called choriocarcinoma syndrome, in cases with a high hCG level, which indicates a rapidly progressive and high-volume choriocarcinoma.
一位 40 岁男性因转移性睾丸癌被转诊至我院。计算机断层扫描显示多个肺部、肝脏和腹膜后淋巴结转移。此外，磁共振成像显示多个脑转移。在高位睾丸切除术的次日开始接受博来霉素、依托泊苷和顺铂诱导化疗。手术标本的病理诊断为卵黄囊癌。血清人绒毛膜促性腺激素（hCG）明显升高至 630,000 mIU/ml，提示转移部位存在绒毛膜癌成分。随后，该患者因肺出血而发生呼吸衰竭。强化支持性护理防止了致命结局的发生。治疗晚期睾丸肿瘤的医生应该意识到，在 hCG 水平较高的情况下，存在一种称为绒毛膜癌综合征的急性肺出血的潜在并发症，这表明存在迅速进展和大容量的绒毛膜癌。
