Cancer Res Treat.  2009 Dec;41(4):229-232.

Mixed Testicular Germ Cell Tumor Presenting as Metastatic Pure Choriocarcinoma Involving Multiple Lung Metastases That Was Effectively Treated with High-dose Chemotherapy

• Lee SC
• Kim KH
• Kim SH
• Lee NS
• Park HS
• Won JH

Abstract

Choriocarcinoma in the testis is very rare, and it represents less than 1% (0.3%) of all the testicular germ cell tumors. It is a particularly aggressive variant of non-seminoma tumor, which is characterized by a high serum beta-HCG level and multiple lung metastases. The optimal management for this disease remains undefined. We report here on a case of choriocarcinoma with multiple lung metastases, and the patient has achieved continuous remission for 2 years after combination chemotherapy of BEP (bleomycin, etoposide and cisplatin) and sequential high-dose chemotherapy with autologous peripheral stem cell rescue.

Keyword

Neoplasms; Germ cell and embryonal; Testicular choriocarcinoma; High-dose chemotherapy

MeSH Terms

Choriocarcinoma
Drug Therapy, Combination
Etoposide
Female
Germ Cells
Humans
Lung
Neoplasm Metastasis
Neoplasms, Germ Cell and Embryonal
Pregnancy
Stem Cells
Testicular Neoplasms
Testis
Etoposide
Neoplasms, Germ Cell and Embryonal
Testicular Neoplasms

Figure

• 

  Fig. 1 The abdominopelvic CT shows multiple enlarged and conglomerated lymph nodes with central necrosis in the paraaortic, aortocaval and retrocaval areas.

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  Fig. 2 Chest CT shows multiple enlarged lymph nodes with central necrosis in the subcarinal area and hematogenous pulmonary nodules in both lungs.

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  Fig. 3 The right testis gross appearance (A) and H-E staining (×40), (B) revealed mature teratoma without dermoid and epidrmoid cysts.

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  Fig. 4 The gross appearance of the wedge-resected lung (A) and the H-E stain (×200), (B) revealed the presence of multinucleated syncytiotrophoblastic cells and extensive hemorrhagic necrosis.

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  Fig. 5 The initial chest PA (A) and the chest PA taken on the 15th day after admission (B). Variable sized round multiple nodules are noted in both lung fields. The chest X-rays show rapid progression of multiple lung metastases between (A) and (B).

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