Groza Daniela, Duerr Donat, Schmid Mathias, Boesch Beatrix
Internal Medicine, Stadtspital Triemli, Zurich, Switzerland.
Oncology, Stadtsspital Triemli, Zürich, Switzerland.
BMJ Case Rep. 2017 Jul 1;2017:bcr-2017-220493. doi: 10.1136/bcr-2017-220493.
We present the case of non-small cell lung cancer (NSCLC) in a 48-year-old woman with an active history of smoking. The patient initially presented to her general practitioner with a progressive swelling on the neck. Further investigations diagnosed a metastatic lung tumour, and palliative chemotherapy was started. After 5 months of treatment, by newly reported amenorrhoea, cautiously before a restaging CT scan of the abdomen, a pregnancy test was performed and was positive. Both the gynaecological examination and the hormonal panel yielded no signs of pregnancy. Immunohistochemically, staining of the tumour was strongly positive for β-subunit of human chorionic gonadotropin (β-hCG) suggesting that the tumour was responsible for high β-hCG levels.Paraneoplastic β-hCG secretion from adenocarcinomas is rare. In the literature, only a few such cases have been reported. Previous studies suggested that the ability to secrete β-hCG in tumours may correlate to some extent to chemoresistance and thus, to a worse prognosis.
我们报告了一例48岁有吸烟史的非小细胞肺癌(NSCLC)女性患者。患者最初因颈部逐渐肿胀就诊于全科医生。进一步检查诊断为转移性肺肿瘤,并开始进行姑息化疗。治疗5个月后,因新出现的闭经,在谨慎地进行腹部再分期CT扫描之前,进行了妊娠试验,结果呈阳性。妇科检查和激素检查均未发现妊娠迹象。免疫组化显示,肿瘤对人绒毛膜促性腺激素β亚基(β-hCG)染色呈强阳性,提示肿瘤是导致β-hCG水平升高的原因。腺癌旁分泌β-hCG很少见。文献中仅报道了少数此类病例。先前的研究表明,肿瘤分泌β-hCG的能力可能在一定程度上与化疗耐药性相关,从而与较差的预后相关。