Gasparri Roberto, Sedda Giulia, Brambilla Daniela, Girelli Lara, Diotti Cristina, Spaggiari Lorenzo
Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
Department of Data Management, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
J Clin Med. 2019 Nov 19;8(11):2018. doi: 10.3390/jcm8112018.
Choriocarcinoma is a rare malignant disease that is usually associated with a gestational event. Lung metastasis with no evident primary origin and choriocarcinoma, which mimics features of non-small-cell lung cancer, might be misdiagnosed as adenocarcinoma or large-cell carcinoma. This is a pivotal clinical concern since the tumor can lead to various symptoms, seriously affecting the quality of life and can escalate rapidly, with a high mortality rate, compared to lung cancer. We reported a case of a 37-year-old woman with a history of one-year enhancement of beta-human chorionic gonadotropin levels and only a single nodule in the right upper lobe, with no abnormal findings on the gynecological investigation. Then we retrospectively examined all cases treated in the Division of Thoracic Surgery at the European Institute of Oncology in the last twenty years (from 1998 to 2018). This was the first time in our experience that choriocarcinoma presentation was with a single nodule without a gynecological finding. Moreover, the differential diagnosis between lung carcinoma and choriocarcinoma was achieved only after surgical removal. As confirmed by our literature search, precise and expedited differential diagnosis is essential in choriocarcinoma care (both with single or multiple metastases), to successfully remove the tumor and increase the patient's chances of survival.
绒毛膜癌是一种罕见的恶性疾病，通常与妊娠事件相关。无明显原发灶的肺转移以及具有非小细胞肺癌特征的绒毛膜癌，可能会被误诊为腺癌或大细胞癌。这是一个关键的临床问题，因为该肿瘤会引发各种症状，严重影响生活质量，且与肺癌相比，其病情可能迅速恶化，死亡率很高。我们报告了一例37岁女性病例，其β-人绒毛膜促性腺激素水平升高一年，右上叶仅有一个结节，妇科检查未发现异常。然后我们回顾性研究了欧洲肿瘤研究所胸外科在过去二十年（1998年至2018年）治疗的所有病例。在我们的经验中，这是首次出现绒毛膜癌表现为单个结节且无妇科异常发现的情况。此外，仅在手术切除后才实现了肺癌与绒毛膜癌的鉴别诊断。正如我们文献检索所证实的，在绒毛膜癌治疗（无论是单发还是多发转移）中，准确而快速的鉴别诊断对于成功切除肿瘤并提高患者生存率至关重要。
