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]

scholarly journals Don’t cancel the surgery just yet! A case report of positive preoperative pregnancy test due to a soft tissue sarcoma production of ectopic beta human chorionic gonadotropin

Rare Tumors ◽  
2018 ◽  
Vol 10 ◽  
pp. 203636131878972
Author(s):  
Alan Todd Blank ◽  
Mazdak Khalighi ◽  
R Lor Randall ◽  
Kevin B Jones
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Immunohistochemical Staining ◽  
Elevated Serum ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Beta Human Chorionic Gonadotropin ◽  
Rare Group

Soft tissue sarcomas are a rare group of mesenchymal malignancies which can range from low to high grade. These tumors have different clinical, radiographic, and histopathological characteristics. Beta human chorionic gonadotropin is a naturally secreted hormone by placental syncytiotrophoblast cells during pregnancy. On very rare occasions, sarcomas can develop the ability to ectopically produce human chorionic gonadotropin. Very few cases exist in the literature of soft tissue sarcomas expressing this hormone. We report the case of a 55-year-old female who presented with a posterior thigh soft tissue sarcoma who on the day of surgical resection was found to have an unusually elevated serum human chorionic gonadotropin. Positive immunohistochemical staining of the resected mass confirmed the sarcoma as the source of the beta human chorionic gonadotropin.

Serum and Cerebrospinal Fluid Human Chorionic Gonadotropin (hCG) and alpha-fetoprotein (AFP) in Intracranial Germ Cell Tumors

2002 ◽  
Vol 17 (2) ◽  
pp. 112-118 ◽  
Author(s):  
E. Seregni ◽  
M. Massimino ◽  
S. Nerini Molteni ◽  
F. Pallotti ◽  
B. van der Hiel ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Germ Cell ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Germ Cell Tumors ◽  
High Serum ◽  
Response To Therapy ◽  
Alpha Fetoprotein ◽  
Intracranial Germ Cell Tumors

We report a retrospective study on serum and cerebrospinal fluid (CSF) alpha-fetoprotein (AFP) and β-human chorionic gonadotropin (βhCG) determination in a series of 30 patients bearing intracranial germ cell tumors. At diagnosis five patients had high serum and CSF AFP levels. No patient had positive serum AFP and negative CSF AFP or vice versa. Twelve of 30 patients had serum βhCG levels above 5 mIU/mL, eight had high βhCG only in CSF, and ten were completely negative. During treatment and follow-up both markers were accurate indicators of the response to therapy, decreasing rapidly and often becoming normal already after the first phase of treatment. We conclude that these two markers, and mostly βhCG, may be useful in the diagnosis and monitoring of the response to therapy of patients with intracranial germ cell tumors.

Melanoma: Prognostic Factors and Factors Predictive of Response to Therapy

2020 ◽  
Vol 27 (17) ◽  
pp. 2792-2813
Author(s):  
Martina Strudel ◽  
Lucia Festino ◽  
Vito Vanella ◽  
Massimiliano Beretta ◽  
Francesco M. Marincola ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lactate Dehydrogenase ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Elevated Serum ◽  
Predictive Biomarkers ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Prognostic Features ◽  
Programmed Death

Background: A better understanding of prognostic factors and biomarkers that predict response to treatment is required in order to further improve survival rates in patients with melanoma. Predictive Biomarkers: The most important histopathological factors prognostic of worse outcomes in melanoma are sentinel lymph node involvement, increased tumor thickness, ulceration and higher mitotic rate. Poorer survival may also be related to several clinical factors, including male gender, older age, axial location of the melanoma, elevated serum levels of lactate dehydrogenase and S100B. Predictive Biomarkers: Several biomarkers have been investigated as being predictive of response to melanoma therapies. For anti-Programmed Death-1(PD-1)/Programmed Death-Ligand 1 (PD-L1) checkpoint inhibitors, PD-L1 tumor expression was initially proposed to have a predictive role in response to anti-PD-1/PD-L1 treatment. However, patients without PD-L1 expression also have a survival benefit with anti-PD-1/PD-L1 therapy, meaning it cannot be used alone to select patients for treatment, in order to affirm that it could be considered a correlative, but not a predictive marker. A range of other factors have shown an association with treatment outcomes and offer potential as predictive biomarkers for immunotherapy, including immune infiltration, chemokine signatures, and tumor mutational load. However, none of these have been clinically validated as a factor for patient selection. For combined targeted therapy (BRAF and MEK inhibition), lactate dehydrogenase level and tumor burden seem to have a role in patient outcomes. Conclusions: With increasing knowledge, the understanding of melanoma stage-specific prognostic features should further improve. Moreover, ongoing trials should provide increasing evidence on the best use of biomarkers to help select the most appropriate patients for tailored treatment with immunotherapies and targeted therapies.

scholarly journals Lung neoplasm mimicking as ectopic pregnancy due to paraneoplastic secretion of human chorionic gonadotropin: a case report and literature review

2021 ◽  
Author(s):  
Jin Peng ◽  
Shangge lv ◽  
Lin Liu ◽  
Shuai Feng ◽  
Naidong Xing
Keyword(s):  
Systematic Review ◽  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Lung Neoplasm ◽  
High Serum ◽  
Pregnancy Test ◽  
Positive Pregnancy Test ◽  
Β Hcg ◽  
Present Systematic Review

Abstract Purpose The present systematic review aimed to examine the relationship between lung neoplasm and human chorionic gonadotropin (HCG). Especially, women with lung neoplasm mimicking as ectopic pregnancy were explored. Methods A rare case of lung neoplasm with high serum β-HCG, which was initially thought to be ectopic pregnancy, was reported. A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2020. Results Studies assessed lung neoplasm patients with positive HCG were included. Twenty studies, including 24 patients, were included. These cases illustrate the importance of considering the possibility of paraneoplastic secretion of β-HCG in patients who have a positive pregnancy test. This may prevent a delay in the diagnosis and treatment of malignancy in young women. Of the 24 cases, only 7 (29.17%) were managed surgically; others were managed conservatively or with chemotherapy or radiation. Conclusion The present systematic review shows the need to re-awaken awareness and high index of suspicion to lung neoplasm diagnosis in patients with positive pregnancy test.

Hyperthyroidism in men with germ cell tumors and high levels of beta-human chorionic gonadotropin

Cancer ◽  
2010 ◽  
Vol 69 (5) ◽  
pp. 1286-1290 ◽  
Author(s):  
Sergio A. Giralt ◽  
Francisco Dexeus ◽  
Robert Amato ◽  
Avishay Sella ◽  
Christopher Logothetis
Keyword(s):  
Germ Cell ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Germ Cell Tumors ◽  
Beta Human Chorionic Gonadotropin
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