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Primary pulmonary choriocarcinoma in a four month old boy complicated with precocious puberty
T Otsuka1, Y Ohshima, Y Sunaga
1Department of Pediatrics, Gunma University School of Medicine, Japan.
Insights
A rare case of pulmonary choriocarcinoma in an infant caused precocious puberty due to elevated human chorionic gonadotropin (HCG). Current treatments showed only temporary success, highlighting the need for better therapeutic strategies.
Area of Science:
- Pediatric Oncology
- Reproductive Endocrinology
Background:
- Pulmonary choriocarcinoma is a rare germ cell tumor.
- Elevated human chorionic gonadotropin (HCG) can cause isosexual precocious puberty.
Observation:
- A four-month-old boy presented with isosexual precocious puberty and a lung tumor.
- Diagnostic imaging confirmed a right lung mass; serum HCG was significantly elevated.
Findings:
- Histological examination confirmed pulmonary choriocarcinoma with positive HCG.
- Surgical resection and conventional chemotherapy (cisplatin, vinblastine, bleomycin) provided only transient tumor response and HCG normalization.
Implications:
- This case underscores the challenges in treating infant pulmonary choriocarcinoma.
- More effective treatment regimens are crucial for improving outcomes in such rare pediatric malignancies.
Abstract:
A four month old boy with pulmonary choriocarcinoma, showing iso-sexual precocious puberty is reported. His serum human chorionic gonadotropin (HCG) was highly elevated. A round isolated tumor in the right lung, found by chest X-ray, magnetic resonance imaging and gallium scintigraphy, was removed surgically a month and a half after clinical manifestations were noticed. It was determined to be choriocarcinoma on the basis of histological findings and positive HCG on histochemical examination. Skull irradiation and chemotherapy (cisplatinum, vinblastine and bleomycin) had only a transient effect on reducing tumor size and normalizing the serum level of HCG. This case suggests that a more effective treatment regimen needs to be established.