Primary Pulmonary Choriocarcinoma with Multiple Lung Metastases: A Case Report

原發性肺絨毛膜癌併多重肺轉移－病例報告

石智元(Chi-Won Suk) ； 余明治(Ming-Chih Yu) ； 劉興璟(H. Eugene Liu) ； 方嘉郎(Chia-Lang Fang)

《胸腔醫學》 26卷5期 (2011/10) Pp. 268-274

https://doi.org/10.29806/TM.201110.0004

摘要

原發性肺絨毛膜癌是一極少見與懷孕非相關的惡性滋養層組織的一種癌症，亦是屬於生殖細胞癌的一種。目前在世界上只有少數的文獻有報告過此種疾病。我們在此報告一位43歲的男性患者因漸進式呼吸困難、乾咳及胸痛約兩星期而就醫。胸部X光及電腦斷層顯示出一巨大的左肺腫瘤併多發性肺節結，理學檢查時也發現病人有男性女乳症，且血液中的人類絨毛膜性腺激素異常上升，故安排超音導引切片檢查。病理結果經免疫化學染色顯示為絨毛膜細胞癌，因此病人最後被診斷為原發性肺絨毛膜細胞癌。由於此疾病是一極為罕見的惡性腫瘤，往後更多的研究及報告將有助於臨床醫師對此疾病的進一步了解及治療，並可能促進改善此疾病的存治率及預後。

關鍵字

原發性 ； 肺 ； 絨毛膜細胞癌

並列摘要

Primary pulmonary choriocarcinoma (PPC) is an extremely rare malignant trophoblastic cancer unrelated to pregnancy, and is 1 of a subset of germ cell tumors. Only a few cases have been reported in the medical literature worldwide. We reported the case of a 43-year-old male patient who suffered from progressive dyspnea, dry cough and chest pain for about 2 weeks. A huge left lung mass associated with bilateral multiple pulmonary nodules was detected by chest radiography and computerized tomography. Bilateral gynecomastia associated with a high level of serum beta-human chorionic gonadotropin (β-HCG) was found during examination. Echo-guided biopsy showed a picture of carcinoma arranged in nests and in a decohesive pattern. Multinucleated syncytiotrophoblast-like tumor cells displayed nuclear hyperchromasia and pleomorphism. Immunohistochemical results showed positive responses to human leukocyte antigen G andβ-HCG. Choriocarcinoma was the definitive diagnosis. Because of the rarity of this malignancy, further studies and more reports of PPC worldwide may help clinicians become more knowledgeable about the clinicopathologic condition. The more understanding there is about the disease, the greater the improvement in the prognosis and survival rate that may be achieved.

並列關鍵字

primary ； pulmonary ； choricocarcioma