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Presented by Dr. Andres Matoso and prepared by Dr. Sintawat Wangsiricharoen.
Adult male with history of germ cell tumor of testis, now with lung tumor.
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Question 1 of 1
1. Question
Adult male with history of germ cell tumor of testis, now with lung tumor.
Correct
Correct: B
Histology: Sections show a solid mass composed of round cells with eosinophilic cytoplasm with single nuclei and peripheral multinucleated cells with more amphophilic cytoplasm.
Discussion: Choriocarcinoma frequently metastasizes to the lung and to many other organs causing bleeding as a clinical presentation, either in the form . In this case, the syncytiotrophoblastic cells are subtle and located towards the edge of the tumor, which could make its recognition more challenging. In contrast to seminoma and embryonal carcinoma, choriocarcinoma is negative for OCT3/4 and positive for hCG, SALL4, and GATA3. Cytokeratin stains can be positive leading to confusion with carcinoma. Serum beta-hCG is elevated.
References
1. Elzamly S, Torabi A, Padilla O. Testicular Choriocarcinoma Metastasizing to the Small Bowel Causing Intussusception: Case Report. J Gastrointest Cancer. 2019 Dec;50(4):1005-1008.
2. Lee SC, Kim KH, Kim SH, Lee NS, Park HS, Won JH. Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy. Cancer Res Treat. 2009 Dec;41(4):229-32.
Incorrect
Correct: B
Histology: Sections show a solid mass composed of round cells with eosinophilic cytoplasm with single nuclei and peripheral multinucleated cells with more amphophilic cytoplasm.
Discussion: Choriocarcinoma frequently metastasizes to the lung and to many other organs causing bleeding as a clinical presentation, either in the form . In this case, the syncytiotrophoblastic cells are subtle and located towards the edge of the tumor, which could make its recognition more challenging. In contrast to seminoma and embryonal carcinoma, choriocarcinoma is negative for OCT3/4 and positive for hCG, SALL4, and GATA3. Cytokeratin stains can be positive leading to confusion with carcinoma. Serum beta-hCG is elevated.
References
1. Elzamly S, Torabi A, Padilla O. Testicular Choriocarcinoma Metastasizing to the Small Bowel Causing Intussusception: Case Report. J Gastrointest Cancer. 2019 Dec;50(4):1005-1008.
2. Lee SC, Kim KH, Kim SH, Lee NS, Park HS, Won JH. Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy. Cancer Res Treat. 2009 Dec;41(4):229-32.
