Narushima M, Katsumura Y, Ootsuka H, Shimizu S, Takagi H, Akisawa T, Tanaka K, Suzuki H, Noguchi E, Suzuki T
Department of Internal Medicine, Showa University Fujigaoka Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Feb;28(2):374-8.
A 25-year-old man was admitted to our hospital because of hemosputum and abnormal shadows on chest X-ray film. The chest film showed a mass shadow located in the right hilum and multiple coin lesions in bilateral lung fields. The chest CT scan showed a bulky mass sized 7 cm X 6 cm at the anterior mediastinum. This case was suspected to be choriocarcinoma because he was young, it was rapidly progressive and also because serum LDH and beta-HCG values were raised. The specimens obtained by surgical biopsy showed HCG-stain positive syncytiotrophoblasts. Cancer chemotherapy was started with CDDP and other anti-cancer drugs, but he succumbed about 3 months after admission. Autopsy findings showed no scar formation of his testes, and the primary lesion was finally diagnosed to be in the anterior mediastinum. Extra-gonadal choriocarcinoma is rare, and beta-HCG is very useful for its diagnosis and the follow-up of the clinical course.
一名25岁男性因咯血及胸部X线片出现异常阴影而入院。胸部X线片显示右肺门有一肿块阴影，双侧肺野有多个钱币状病灶。胸部CT扫描显示前纵隔有一个大小为7厘米×6厘米的巨大肿块。该病例被怀疑为绒毛膜癌，因为患者年轻，病情进展迅速，且血清乳酸脱氢酶（LDH）和β-人绒毛膜促性腺激素（β-HCG）值升高。手术活检获取的标本显示HCG染色阳性的合体滋养层细胞。开始使用顺铂及其他抗癌药物进行癌症化疗，但他在入院后约3个月死亡。尸检结果显示其睾丸无瘢痕形成，最终诊断原发性病灶位于前纵隔。性腺外绒毛膜癌罕见，β-HCG对其诊断及临床病程的随访非常有用。
