BetaHCG secretion by a pulmonary adenocarcinoma
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
BetaHCG secretion by a pulmonary adenocarcinoma Cécile Vicier1,2*, Emeline Tabouret1,2, Agnès Tallet3, Anthony Gonçalves1,2, Bruno Chetaille4, Patrice Viens1,2 and Anne Madroszyk1
Abstract We report a rare case of metastatic non-small-cell lung cancer in a 43-year-old woman with a history of smoking. The tumor secreted human chorionic gonadotropin and its beta subunit (BetaHCG). The patient presented with amenorrhea, a positive pregnancy test and chest pain. A physical examination and investigations revealed no pregnancy, and it was determined that a paraneoplastic syndrome stemming from a pulmonary tumor was responsible for the secretion of BetaHCG. This secretion decreased with tumor response to chemotherapy. Only a few reports of paraneoplastic BetaHCG secretion can be found in the literature for several different cancers. Keywords: BetaHCG, Non-small-cell lung cancer, Paraneoplastic syndromes, Ectopic pregnancy
Background The lung cancer mortality rate has been declining in men, especially for those between age 35 and 44 years of age. The decline mirrors a significant reduction in men’s smoking habits. However, lung cancer mortality in women has been increasing, especially in younger women. Moreover, recent studies have shown that female smokers have a 10-year reduced lifespan compared with their non-smoking counterparts [1]. Cancer diagnosis can be made from primary tumor, metastatic lesions or, less commonly, paraneoplastic syndromes, primarily encountered in lung cancer. Paraneoplastic syndromes (neoplasm-associated alterations resulting from damage to organs or tissues that are remote from the tumor site) are rare. They occur in 8% of cancer patients and frequently develop with advanced disease but may appear earlier than symptoms of the primary tumor itself, leading to a cancer diagnosis [2]. We report here the case of a young woman with a history of smoking who presented with a beta human chorionic gonadotropin (BetaHCG) paraneoplastic secretion, an indicator of non-small-cell lung cancer. We subsequently present a
* Correspondence: [email protected] 1 Department of Medical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France 2 Aix-Marseille Université, 13001 Marseille, France Full list of author information is available at the end of the article
comprehensive literature review and discuss prognosis and therapeutic options.
Case presentation A 43-year-old woman (gravida 2, para 1, abortion 1 in 2010) presented with amenorrhea, nausea, chest pain and asthenia. Her medical history included a diagnosis of hepatitis C 2 years ago, weaned heroin and cocaine addiction and active tobacco addiction. She had smoked two packs of cigarettes daily for a period of 20 years and drank two glasses of wine per day. She had no treatment or allergy. When she presented at the hospital, pregnancy was suspected because of a 2-month history of amenorrhea and lack of consistent use of contraception. A qualitative BetaHCG test was positive. Pelvic exa
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