Primary hepatic choriocarcinoma in a 49-year-old man: Report of a case |
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Authors: | Ryosuke Sekine Masanobu Hyodo Masayuki Kojima Yoshiyuki Meguro Akifumi Suzuki Taku Yokoyama Alan T Lefor Norio Hirota |
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Affiliation: | Ryosuke Sekine;Masanobu Hyodo;Masayuki Kojima;Yoshiyuki Meguro;Akifumi Suzuki;Taku Yokoyama;Alan T Lefor;Norio Hirota;Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan;Department of Surgery, Hitachiomiya Saiseikai Hospital, Ibaraki 319-2256, Japan;Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan;Department of Pathology, Hirota Institute for Surgical Pathology, Tochigi 329-0403, Japan; |
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Abstract: | We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course. The patient was a 49-year-old man who presented with acute right-sided abdominal pain. There were no masses palpable on physical examination. Radiographic findings showed large multi-nodular tumors mainly in the right lobe of the liver. Fludeoxyglucose-positron emission tomography scan showed uptake only in the liver, and no uptake in the testes. We initially planned to perform a liver resection for the presumed diagnosis of intra-hepatic cholangiocarcinoma. However, the tumors grew rapidly and ruptured. Multiple lung metastases rapidly developed resulting in respiratory failure, preventing liver resection or even biopsy. He died 60 d after initial presentation with no pathological diagnosis. Postmortem studies included histopathological and immunohistological examinations which diagnosed a primary choriocarcinoma of the liver. Primary hepatic choriocarcinoma is very rare but should be considered in the differential diagnosis of a liver tumor in a middle aged man. Establishing this diagnosis may enable treatment of the choriocarcinoma. Liver biopsy and evaluation of serum human chorionic gonadotropin are recommended in these patients. |
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Keywords: | Hepatic choriocarcinoma Male Human chorionic gonadotropin Liver biopsy Fludeoxyglucose-positron emission tomography |
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