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1. Naito Y, Akeda K, Kasai Y, Matsumine A, Tabata T, Nagao K, Uchida A: Lumbar metastasis of choriocarcinoma. Spine (Phila Pa 1976); 2009 Jul 1;34(15):E538-43
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  • [Title] Lumbar metastasis of choriocarcinoma.
  • STUDY DESIGN: A case of lumbar metastasis of a choriocarcinoma is presented.
  • OBJECTIVE: To present and review a rare case of metastatic choriocarcinoma in the lumbar spine.
  • SUMMARY OF BACKGROUND DATA: Choriocarcinoma is a highly anaplastic malignancy derived from trophoblastic cells characterized by the secretion of human chorionic gonadotropin (hCG) and early hematogenous metastasis.
  • However, metastatic choriocarcinoma in the spine is extremely rare.
  • Although 2 cases of metastasis in lumbar and/or sacral vertebra have been reported, the efficacy of surgical treatment for the spinal metastasis of choriocarcinoma is not yet known.
  • METHODS: The clinical course, radiologic features, pathology, and outcome of the treatment of metastatic choriocarcinoma of the lumbar spine is reported.
  • After computed tomography-guided needle biopsy, a clinical and pathologic diagnosis of lumbar metastasis of choriocarcinoma was made.
  • CONCLUSION: We have reported a rare case of lumbar metastasis of choriocarcinoma after a normal-term pregnancy.
  • This is the first report of lumbar metastasis of choriocarcinoma treated by spinal surgery.
  • Because surgical resection of a lumbar metastasis of choriocarcinoma involves a substantial risk of profuse hemorrhage, local recurrence and the spread of metastasis, multiagent chemotherapy in combination with radiotherapy should be preformed before surgical resection.
  • [MeSH-major] Choriocarcinoma / secondary. Lumbar Vertebrae / pathology. Pregnancy Complications, Neoplastic / pathology. Spinal Neoplasms / secondary. Uterine Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / blood. Biopsy. Chorionic Gonadotropin / blood. Chorionic Gonadotropin / secretion. Drug Therapy / methods. Drug Therapy / standards. Epidural Neoplasms / secondary. Fatal Outcome. Female. Humans. Hydatidiform Mole / complications. Hydatidiform Mole / physiopathology. Lung Neoplasms / secondary. Neoplasm Metastasis / pathology. Neoplasm Metastasis / physiopathology. Neoplasm Recurrence, Local. Neurosurgical Procedures. Pregnancy. Treatment Failure

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  • (PMID = 19564760.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin
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2. Bohlmann MK, Eckstein FS, Allemann Y, Stauffer E, Carrel TP: Intracardiac resection of a metastatic choriocarcinoma. Gynecol Oncol; 2002 Jan;84(1):157-60
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  • [Title] Intracardiac resection of a metastatic choriocarcinoma.
  • BACKGROUND: Postpartal choriocarcinoma is a rare complication of pregnancy, which usually responds well to chemotherapy, even in advanced stages.
  • Metastatic heart involvement typically characterizes a widely advanced disease, requiring palliative treatment.
  • CASE: A 41-year-old woman with disseminated choriocarcinoma following a full-term pregnancy presented with clinical signs of severe dyspnea.
  • Histological examination revealed a metastatic thrombus of a choriocarcinoma that had obstructed the right inferior pulmonary vein at the entrance to the left atrium.
  • CONCLUSION: Tumor reductive surgery followed by high-dose chemotherapy might be a useful approach in patients with metastatic choriocarcinoma even in cases of rare tumor sites.
  • [MeSH-major] Choriocarcinoma / secondary. Choriocarcinoma / surgery. Heart Neoplasms / secondary. Heart Neoplasms / surgery. Pregnancy Complications, Neoplastic / surgery
  • [MeSH-minor] Adult. Female. Heart Atria / pathology. Heart Atria / surgery. Humans. Postpartum Period. Pregnancy. Uterine Neoplasms / drug therapy. Uterine Neoplasms / pathology. Uterine Neoplasms / surgery

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  • (PMID = 11748994.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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3. Goodarzi MO, Van Herle AJ: Thyrotoxicosis in a male patient associated with excess human chorionic gonadotropin production by germ cell tumor. Thyroid; 2000 Jul;10(7):611-9
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  • We report a case of a man with thyrotoxicosis due to excess production of human chorionic gonadotropin (hCG) by metastatic choriocarcinoma, followed by alterations of his thyroid function tests by nonthyroidal illness.
  • Patients with this syndrome usually have widespread choriocarcinoma and relatively few symptoms of thyrotoxicosis.
  • Typically, if the patient survives the metastatic germ cell tumor, the thyrotoxicosis resolves as the hCG levels decrease after chemotherapy directed at the choriocarcinoma.
  • Only rarely are specific antithyroid medications required.
  • In general, these patients have a poor prognosis due to the usually widespread nature of the germ cell tumor at the time of diagnosis.
  • [MeSH-major] Choriocarcinoma / metabolism. Chorionic Gonadotropin / biosynthesis. Testicular Neoplasms / metabolism. Thyrotoxicosis / etiology

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  • (PMID = 10958315.001).
  • [ISSN] 1050-7256
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin
  • [Number-of-references] 34
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4. Mamelak AN, Withers GJ, Wang X: Choriocarcinoma brain metastasis in a patient with viable intrauterine pregnancy. Case report. J Neurosurg; 2002 Aug;97(2):477-81
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  • [Title] Choriocarcinoma brain metastasis in a patient with viable intrauterine pregnancy. Case report.
  • The authors report the case of a woman who presented during her 30th week of pregnancy with a large brain metastasis from a previously undetected metastatic choriocarcinoma.
  • Medical management included a regimen of high-dose corticosteroid medications for 36 hours, followed by cesarean delivery of the fetus and craniotomy to remove the metastatic tumor, chemotherapy and radiation therapy were begun within 1 week postsurgery.
  • This is only the second report of a metastatic choriocarcinoma associated with a simultaneous viable intrauterine pregnancy, and the only case in which surgical removal of a brain metastasis was required.
  • [MeSH-major] Brain Neoplasms / secondary. Brain Neoplasms / surgery. Choriocarcinoma / secondary. Choriocarcinoma / surgery. Pregnancy Complications, Neoplastic / pathology. Pregnancy Complications, Neoplastic / surgery. Pregnancy Outcome. Uterine Neoplasms / pathology


5. McNally OM, Tran M, Fortune D, Quinn MA: Successful treatment of mother and baby with metastatic choriocarcinoma. Int J Gynecol Cancer; 2002 Jul-Aug;12(4):394-8
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  • [Title] Successful treatment of mother and baby with metastatic choriocarcinoma.
  • The second case of successful management of a mother and neonate with metastatic choriocarcinoma is described.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Choriocarcinoma / drug therapy. Choriocarcinoma / surgery. Uterine Neoplasms / drug therapy. Uterine Neoplasms / surgery
  • [MeSH-minor] Adult. Brain Neoplasms / drug therapy. Brain Neoplasms / secondary. Chorionic Gonadotropin / blood. Etoposide / administration & dosage. Female. Humans. Infant, Newborn. Infectious Disease Transmission, Vertical. Kidney Neoplasms / drug therapy. Kidney Neoplasms / secondary. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Male. Paclitaxel / administration & dosage. Pregnancy. Pregnancy Complications, Neoplastic / pathology

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  • (PMID = 12144689.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 6PLQ3CP4P3 / Etoposide; P88XT4IS4D / Paclitaxel
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6. Landau D, Maor E, Maymon E, Rabinovich A, Piura B: Intraplacental choriocarcinoma metastasizing to the maternal lung. Eur J Gynaecol Oncol; 2006;27(1):29-32
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  • [Title] Intraplacental choriocarcinoma metastasizing to the maternal lung.
  • BACKGROUND: Although normal pregnancy is the precursor of 25% of cases of maternal choriocarcinoma, intraplacental choriocarcinoma in an otherwise normal placenta associated with viable pregnancy has rarely been reported.
  • CASE: Examination of the placenta after delivery of a pale and small-for-date infant at term revealed intraplacental choriocarcinoma.
  • There was no evidence of metastatic disease in the mother or child, but the mother exhibited postpartum rising levels of beta-HCG.
  • Nine months later, she presented with metastatic choriocarcinoma of the lung.
  • Eleven courses of the multi-drug EMA CO regimen effected a decrease of beta-HCG to normal and disappearance of lung metastases.
  • CONCLUSIONS: This case is an example of natural disease progression of intraplacental choriocarcinoma metastasizing to the mother.
  • Furthermore, it supports common knowledge that the multi-drug EMA CO regimen is effective treatment in poor prognosis metastatic choriocarcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Choriocarcinoma / secondary. Lung Neoplasms / secondary. Pregnancy Complications, Neoplastic / diagnosis. Pregnancy Outcome. Uterine Neoplasms / pathology


7. Numnum TM, Leath CA 3rd, Straughn JM Jr, Conner MG, Barnes MN 3rd: Occult choriocarcinoma discovered by positron emission tomography/computed tomography imaging following a successful pregnancy. Gynecol Oncol; 2005 May;97(2):713-5
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  • [Title] Occult choriocarcinoma discovered by positron emission tomography/computed tomography imaging following a successful pregnancy.
  • She had a history of molar pregnancy and persistent GTD requiring multi-agent chemotherapy.
  • Metastatic evaluation with computed tomography and magnetic resonance imaging showed no evidence of GTD.
  • The patient underwent an exploratory laparotomy that revealed metastatic choriocarcinoma in the left broad ligament.
  • CONCLUSION: PET/CT may be useful in the evaluation of occult choriocarcinoma when conventional imaging fails to identify metastatic disease.
  • [MeSH-major] Choriocarcinoma / radionuclide imaging. Gestational Trophoblastic Disease / radionuclide imaging

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  • (PMID = 15863190.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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8. Chen LM, Lengyel ER, Bethan Powell C: Single-agent pulse dactinomycin has only modest activity for methotrexate-resistant gestational trophoblastic neoplasia. Gynecol Oncol; 2004 Jul;94(1):204-7
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  • [Title] Single-agent pulse dactinomycin has only modest activity for methotrexate-resistant gestational trophoblastic neoplasia.
  • OBJECTIVES: To determine the effectiveness of single-agent pulse dactinomycin for methotrexate-resistant low-risk gestational trophoblastic neoplasia (GTN).
  • METHODS: Ten patients with low-risk GTN (WHO/FIGO score <8) previously treated with uterine evacuation and single-agent methotrexate were treated with pulse dactinomycin 1.25 mg/m(2) every 2 weeks.
  • RESULTS: Patients had antecedent pregnancies of complete mole (7), partial mole (1), missed abortion (1), and choriocarcinoma (1).
  • Six of 10 (60%) patients achieved complete remission with single-agent pulse dactinomycin.
  • Two others responded to a 5-day regimen of dactinomycin, 1 responded to a multidrug regimen, and 1 had chemo-resistant disease dying of metastatic choriocarcinoma.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Dactinomycin / therapeutic use. Gestational Trophoblastic Disease / drug therapy. Methotrexate / pharmacology
  • [MeSH-minor] Adult. Drug Administration Schedule. Drug Resistance, Neoplasm. Female. Humans. Middle Aged. Pregnancy. Risk Factors

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  • (PMID = 15262143.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 1CC1JFE158 / Dactinomycin; YL5FZ2Y5U1 / Methotrexate
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9. Amikura T, Aoki Y, Banzai C, Yokoo T, Nishikawa N, Sekine M, Suzuki M, Tanaka K: Metastatic choriocarcinoma successfully treated with paclitaxel and carboplatin after interstitial lung disease induced by EMA-CO. Gynecol Oncol; 2006 Sep;102(3):573-5
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  • [Title] Metastatic choriocarcinoma successfully treated with paclitaxel and carboplatin after interstitial lung disease induced by EMA-CO.
  • BACKGROUND: Well-established first-line chemotherapy (such as EMA-CO) is extraordinary active for gestational choriocarcinoma.
  • However, it causes very serious situation once drug-induced acute interstitial lung disease occurs during the treatment.
  • CASE: A 31-year-old Japanese woman with metastatic choriocarcinoma was treated with EMA-CO as an initial chemotherapy regimen for seven cycles.
  • CONCLUSIONS: Paclitaxel and carboplatin combination is active and appears to be a viable alternative to EMA-CO combination chemotherapy in metastatic choriocarcinoma even after EMA-CO-induced interstitial lung disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carboplatin / therapeutic use. Choriocarcinoma / drug therapy. Choriocarcinoma / secondary. Lung Diseases, Interstitial / chemically induced. Paclitaxel / therapeutic use. Uterine Neoplasms / drug therapy


10. Choi HJ, Park IA: Fine needle aspiration cytology of metastatic choriocarcinoma presenting as a breast lump. A case report. Acta Cytol; 2004 Jan-Feb;48(1):91-4
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  • [Title] Fine needle aspiration cytology of metastatic choriocarcinoma presenting as a breast lump. A case report.
  • BACKGROUND: While choriocarcinoma is a rapidly invasive, widely metastasizing malignancy, it responds well to chemotherapy, so it is important to obtain an early diagnosis.
  • We report the fine needle aspiration cytology (FNAC) of a case of choriocarcinoma metastatic to the breast.
  • The breast mass was clinically suspected to be a metastatic lung cancer.
  • FNAC of the breast showed a malignant tumor that had been misdiagnosed as a metastatic non-small cell carcinoma of the lung.
  • Histologic examination of a nasal biopsy revealed metastatic choriocarcinoma.
  • CONCLUSION: The cytologic features of choriocarcinoma are quite characteristic, with side-by-side, malignant, mononucleated cells and multinucleated giant cells corresponding to cytotrophoblasts and syncytiotrophoblasts, respectively.
  • [MeSH-major] Breast Neoplasms / secondary. Choriocarcinoma / secondary. Lung Neoplasms / secondary. Nose Neoplasms / secondary. Uterine Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy, Fine-Needle. Cell Nucleus / pathology. Chorionic Gonadotropin, beta Subunit, Human / blood. Cough / etiology. Cough / pathology. Diagnosis, Differential. Epistaxis / etiology. Epistaxis / pathology. Female. Giant Cells / pathology. Hemoptysis / etiology. Hemoptysis / pathology. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Pregnancy. Treatment Outcome


11. Husain SJ, Zubairi AB, Yunus A, Jamil S: Massive hemoptysis as a rare presentation of metastatic choriocarcinoma. J Coll Physicians Surg Pak; 2006 Mar;16(3):235-6
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  • [Title] Massive hemoptysis as a rare presentation of metastatic choriocarcinoma.
  • Choriocarcinoma is an uncommon but rapidly invasive and widely metastasizing tumour.
  • She responded well to therapy once the diagnosis of metastatic choriocarcinoma was established .
  • [MeSH-major] Choriocarcinoma / secondary. Hemoptysis / etiology. Lung Neoplasms / diagnosis. Lung Neoplasms / secondary. Uterine Neoplasms
  • [MeSH-minor] Adult. Antibiotics, Antineoplastic / administration & dosage. Antibiotics, Antineoplastic / therapeutic use. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / therapeutic use. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Bleomycin / therapeutic use. Bronchoalveolar Lavage Fluid. Bronchoscopy. Chorionic Gonadotropin / blood. Cyclophosphamide / administration & dosage. Cyclophosphamide / therapeutic use. Etoposide / administration & dosage. Etoposide / therapeutic use. Female. Follow-Up Studies. Humans. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Radiography, Thoracic. Time Factors. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 16542611.001).
  • [ISSN] 1022-386X
  • [Journal-full-title] Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
  • [ISO-abbreviation] J Coll Physicians Surg Pak
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Pakistan
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Phytogenic; 0 / Chorionic Gonadotropin; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide
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12. Nakano A, Yoshida M, Harada T, Araki A, Pineda L, Iijima M, Sezer C, Zhou L, Maruyama R: Intratubular germ cell neoplasia of unclassified type occupying the whole testis accompanied by a small mature teratoma and metastatic choriocarcinoma and Sertoli cell-only tubules in the other testis. Pathol Int; 2003 Oct;53(10):726-32
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  • [Title] Intratubular germ cell neoplasia of unclassified type occupying the whole testis accompanied by a small mature teratoma and metastatic choriocarcinoma and Sertoli cell-only tubules in the other testis.
  • A 19-year-old man with mild mental retardation was diagnosed as having metastatic choriocarcinoma and a testicular tumor.
  • Histopathological examination of the resected testis revealed the presence of a small lesion of mature teratoma but no trace of choriocarcinoma.
  • The remaining seminiferous tubules were atrophic and lined by large atypical germ cells, which were diagnosed as intratubular germ cell neoplasia of the unclassified type (IGCNU).
  • Immunohistological comparison of staining for several biological markers (Ki-67, c-kit and placental alkaline phosphatase) between cells in the atrophic tubules and those in the dilated tubules indicated a progression of the latter cells to cells with a more proliferative ability.
  • In the opposite testis, examined at autopsy after death due to metastatic choriocarcinoma, all seminiferous tubules were lined by Sertoli cells only.
  • It was therefore assumed that the germ cell tumor of the combined histological type had primarily arisen in the background of IGCNU, and that choriocarcinoma had spontaneously regressed.
  • [MeSH-major] Choriocarcinoma, Non-gestational / secondary. Germinoma / pathology. Neoplasms, Multiple Primary / pathology. Seminiferous Tubules / pathology. Sertoli Cells / pathology. Teratoma / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Drug Therapy. Fatal Outcome. Humans. Immunohistochemistry. Male. Organ Size

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  • (PMID = 14516326.001).
  • [ISSN] 1320-5463
  • [Journal-full-title] Pathology international
  • [ISO-abbreviation] Pathol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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