scholarly journals Gastric Cancer in the Setting of Persistently Elevated Human Chorionic Gonadotropin: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
LaToya R. Walker ◽  
Brian Erler
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Stage Iv ◽  
Signs And Symptoms ◽  
Metastatic Carcinoma ◽  
Abnormal Pregnancy ◽  
Multiple Biopsies ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Diffuse Sclerosis

A 35-year-old woman presented to the emergency room for the evaluation of failed surgical and medical management of a suspected ectopic pregnancy. When imaging studies were performed, she had lymphadenopathy and diffuse sclerosis of the osseous framework. Multiple biopsies were performed and revealed poorly differentiated metastatic carcinoma with signet ring features. Esophagogastroduodenoscopy confirmed the findings of a Stage IV gastric adenocarcinoma. Signs and symptoms of gastric carcinoma are vague. However, to our knowledge, an elevation in human chorionic gonadotropin (hCG) is not an associated finding. Persistence of hCG has many causes from abnormal pregnancy to menopause and other forms of cancer.

Human chorionic gonadotropin (HCG) as a biomarker in sarcoma: A systematic review.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e22503-e22503
Author(s):  
Martin W. Schoen ◽  
Ahmad Al-Taee ◽  
Bassel Jallad
Keyword(s):  
Systematic Review ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Low Cost ◽  
Elevated Serum ◽  
Germ Cell Tumors ◽  
Response To Therapy ◽  
Response To Treatment ◽  
High Grade ◽  
Poorly Differentiated

e22503 Background: Human chorionic gonadotropin (HCG) has been reported in soft tissue sarcoma and osteosarcoma. In some patients, the ectopic production of HCG can lead to delays in diagnosis due to concern for pregnancy or germ cell tumors. Methods: We performed a systematic review of the scientific literature in English using PubMed to categorize cases of sarcoma search terms were HCG, sarcoma, human chorionic gonadotropin and osteosarcoma. Cases of sarcoma associated with HCG production were identified and further categorized by type and grade of tumor. Initial HCG, Peak HCG, response to therapy and case outcome were collected when available. We also included a case seen at our institution of osteosarcoma with ectopic HCG production. Results: We identified 21 manuscripts and 23 cases of patients with both sarcoma and elevated serum HCG. 10/23 patients were male (43%).The most frequent type of sarcoma was osteosarcoma with 9/23 (39%) of cases, leiomyosarcoma was identified in 7/23 (30%) and liposarcoma in 3/23 (13%) of cases. When described, all tumors were high grade or poorly differentiated. 20/23 tumors (87%) had HCG expression of the tumor by immunohistochemistry. Mean initial HCG was 3607 with a peak value of 6188. In 19 cases, HCG was used to monitor disease after treatment and 14/19 (74%) responded with a decrease in HCG after treatment. Of responders, 3 patients were considered cured and 2 were put into remission, while none of the patients without response survived. Overall, outcomes were poor with 16/23 (70%) deaths within one year. Conclusions: Sarcomas that secrete HCG tend to be high grade, poorly differentiated and appear to portend a poor prognosis. When expressed, HCG can be used as a marker of disease and response to therapy. Oncologists should consider checking HCG as a potentially low-cost marker of prognosis and response to treatment in patients with sarcoma. [Table: see text]

The role of systemic chemotherapy in adenocarcinomas of the appendix: Analysis of the National Cancer Database.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 668-668
Author(s):  
Elliot A. Asare ◽  
Carolyn C. Compton ◽  
Nader Hanna ◽  
Sanjay Kakar ◽  
Lauren Kosinski ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Systemic Chemotherapy ◽  
Stage Iv ◽  
Signet Ring Cell ◽  
Mucinous Histology ◽  
Signet Ring ◽  
Stage Iv Disease ◽  
Poorly Differentiated ◽  
Ring Cell ◽  
Well Differentiated

668 Background: Adenocarcinomas of the appendix represent a heterogeneous disease depending upon the presence of mucinous histology, histologic grade, and stage. We sought to explore the interplay of these factors with systemic chemotherapy in a large population dataset. Methods: Patients in the National Cancer Data Base (NCDB) with mucinous, non-mucinous and signet-ring cell type appendiceal neoplasms from 1985-2006 were selected and American Joint Committee on Cancer (AJCC) 7thedition stage was derived. Multivariable cox proportional hazards regression models to predict death using the available variables age, sex, histology, grade, stage, chemotherapy and surgery were developed. Results: 11,881 patients met our inclusion criteria: 50.3% mucinous, 40.5% non-mucinous and 9.2% signet ring cell. 5-yr OS was similar for mucinous (53.6%) and non-mucinous (46.2%), but differences in stage distribution existed with stage IV disease in 26.2% of mucinous vs. 10.6% of non-mucinous cases, p<0.0001. 5-yr OS stratified by grade was similar across stage I-III disease but not for stage IV disease. Median OS for stage IV mucinous and non-mucinous histology was 6.4 and 2.3 for well differentiated (p<0.0001), 2.5 and 1.0 for moderately differentiated (p<0.0001), and 1.5 and 0.8 for poorly differentiated (p<0.0001), respectively. In multivariable modeling for stage I-III disease, adjuvant chemotherapy improved OS for both mucinous and non-mucinous histologies: HR of 0.78 (0.68-0.89; p=0.0002) and 0.83 (0.74-0.94;p=0.002) respectively. For stage IV disease systemic chemotherapy was significant for non-mucinous 0.72 (0.64-0.82; p<0.0001) but not mucinous 0.95 (0.86-1.04;p=0.2), though this was grade dependent. Median OS for chemotherapy vs. no chemotherapy was 6.4 vs. 6.5 yrs (P=1.0) for mucinous well differentiated and 1.6 vs. 1.0 yrs (P=0.0007) for mucinous poorly differentiated. Conclusions: Adjuvant chemotherapy demonstrated a significant OS benefit regardless of histology. However, for stage IV disease the benefit of systemic chemotherapy varied by histology and grade, with well differentiated mucinous appendiceal adenocarcinomas deriving no survival benefit from systemic chemotherapy.

Gestational trophoblastic disease

2020 ◽  
pp. 809-816
Author(s):  
Hextan Y.S. Ngan ◽  
Karen K.L. Chan ◽  
Siew-Fei Ngu
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Elevated Serum ◽  
Normal Pregnancy ◽  
Gestational Trophoblastic Disease ◽  
Good Prognosis ◽  
Abnormal Pregnancy ◽  
Trophoblastic Disease ◽  
Neoplastic Lesion ◽  
Placental Site

Gestational trophoblastic disease (GTD) arises from an abnormal pregnancy which can subsequently develop into a neoplastic lesion and cancer. The most common abnormal pregnancy preceding GTD is usually benign. Molar pregnancy histologically is classified into partial and complete mole. The malignant histological types include choriocarcinoma, placental site trophoblastic tumour, and epithelioid trophoblastic tumour. The presence of abnormal proliferating trophoblastic tissues can be detected by serum human chorionic gonadotropin assays. Hence, a disease entity without histology but characterized by a persistently elevated serum human chorionic gonadotropin concentration after molar or normal pregnancy is named gestational trophoblastic neoplasia and forms part of the GTD spectrum where treatment is required. Treatment of the malignant form of GTD is mostly by chemotherapy with good prognosis.

GASTRIC SIGNET-RING CELL CARCINOMA WITH HYPERSECRETION OF β-HUMAN CHORIONIC GONADOTROPIN AND REVIEW OF THE LITERATUR

2018 ◽  
Vol 40 (2) ◽  
pp. 149-151 ◽  
Author(s):  
W Ben Kridis ◽  
R Ben Hassena ◽  
S Charfi ◽  
N Toumi ◽  
T Boudawara ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Germ Cell Tumors ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell ◽  
Β Hcg

β-Human chorionic gonadotropin (β-HCG) is an embryonic protein secreted by the syncytiotrophoblast of the placenta. The determination of the plasma β-HCG level is routinely used for the diagnosis and the follow-up of germ cell tumors. Some adenocarcinomas have been described as being rarely associated with β-HCG hypersecretion. We report a case of gastric signet-ring cell carcinoma with β-HCG hypersecretion and propose hypotheses to explain the pathogenesis of such hypersecretion.

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