hCG beta producing pineal choriocarcinoma.

Area of Science:

• Neuroendocrinology
• Oncology

Background:

• Intracranial neoplasms can secrete human chorionic gonadotropin beta (hCG beta), a hormone typically associated with pregnancy.
• The clinical significance of hCG beta secretion in non-trophoblastic tumors, particularly those in the pineal and hypothalamic regions, requires further elucidation.

Observation:

• A 19-year-old male presented with hypopituitarism and persistent secondary sexual characteristics, linked to tumors in the pineal and anterior hypothalamus.
• Elevated serum and cerebrospinal fluid (CSF) levels of hCG beta were detected, with LH immunoreactivity attributed to hCG beta, likely causing elevated testosterone.

Findings:

• Cranial irradiation led to tumor undetectability and eradication of hCG beta from serum and CSF.
• The patient later succumbed to an intramedullary metastasis of choriocarcinoma in the cervical spinal cord.
• Review of six previously reported intracranial neoplasms secreting hCG beta revealed only two in the pineal region.

Implications:

• Monitoring hCG beta levels can aid in the early detection of recurrence for intracranial tumors secreting this hormone.
• Patients presenting with precocious puberty or pineal tumors should be evaluated for circulating hCG beta.
• Further research is needed to determine the frequency with which hCG beta-producing tumors cause precocious puberty.