Kang Sandra, Zaidi Ayesha J, Shokouh-Amiri Mohammad, Wiley Elizabeth, Venepalli Neeta K
Division of Internal Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Oncology Clinical Trials Office, University of Illinois at Chicago, Chicago, IL, USA.
J Gastrointest Oncol. 2019 Dec;10(6):1151-1156. doi: 10.21037/jgo.2019.09.08.
Human chorionic gonadotropin (hCG) is a glycoprotein hormone that is used in clinical practice to detect pregnancy and serves as a sensitive marker for trophoblastic tumors. Other organs besides placental trophoblasts naturally express the hormone at low levels, which can be elevated in nontrophoblastic malignancies. Some studies have suggested that elevated β-hCG levels in nontrophoblastic tumors are a sign of aggressive disease and strongly associated with poor prognosis. We describe a case of a 50-year-old post-menopausal woman with metastatic duodenal adenocarcinoma who presented with a negative pregnancy test that later changed to positive. Biopsy of the primary duodenal mass showed positive immunohistochemical expression of β-hCG. The patient was also found to have multiple brain metastases, which is uncommon in gastrointestinal cancer. This is a rare case of paraneoplastic syndrome in a β-hCG-secreting duodenal adenocarcinoma.
人绒毛膜促性腺激素（hCG）是一种糖蛋白激素，在临床实践中用于检测妊娠，并作为滋养层肿瘤的敏感标志物。除胎盘滋养层细胞外，其他器官也会自然地低水平表达该激素，在非滋养层恶性肿瘤中其水平可能会升高。一些研究表明，非滋养层肿瘤中β-hCG水平升高是疾病侵袭性的标志，且与预后不良密切相关。我们描述了一例50岁绝经后女性转移性十二指肠腺癌病例，该患者最初妊娠试验呈阴性，后来变为阳性。十二指肠原发肿块活检显示β-hCG免疫组化表达阳性。该患者还被发现有多处脑转移，这在胃肠道癌中并不常见。这是一例罕见的分泌β-hCG的十二指肠腺癌所致副肿瘤综合征病例。
