Presentation
His presentation suggested chronic, rather than acute, gastrointestinal blood loss. [ncbi.nlm.nih.gov]
Distant site metastasis can be the presenting feature of choriocarcinoma. We present a case of a 58-year-old male presenting as testicular mass, which came out to be pure choriocarcinoma on histopathology and immunohistochemistry. [cancerjournal.net]
Entire Body System
- Multiple Organ Dysfunction Syndrome
Despite the case completed one cycle of cisplatin-based regimen chemotherapy, he died of multiple organ dysfunction syndrome 2 months after surgery. In this report, cutaneous metastasis with testicular choriocarcinoma is extremely rare. [ncbi.nlm.nih.gov]
Immune System
- Inguinal Lymphadenopathy
Physical exam was significant for 9 x 6 centimetre’s mass in the left testis with normal right testis and no inguinal lymphadenopathy. Visual acuity in right eye was 20/20 and left eye was 20/800. [article.sapub.org]
Gastrointestinal
- Gastropathy
Pathology revealed gastritis and reactive gastropathy. A colonoscopy was noted to have blood in the terminal ileum but was otherwise unremarkable. A push enteroscopy revealed a small ulcerated mass in the jejunum. Two hemoclips were placed there. [ncbi.nlm.nih.gov]
- Lower Abdominal Pain
A 33‐year‐old man with a history of undescended testes as a child initially presented with constipation and lower abdominal pain for 1 year. [shmabstracts.com]
- Dysphagia
He subsequently developed dysphagia, hemoptysis, and left groin pain. A chest X‐ray revealed mediastinal widening. A subsequent computerized tomography scan of the chest revealed a large 7 × 8‐cm mediastinal mass with multiple lymph nodes. [shmabstracts.com]
- Early Satiety
He was treated for presumed irritable bowel syndrome, but his symptoms progressed to early satiety and abdominal fullness. He subsequently developed dysphagia, hemoptysis, and left groin pain. A chest X‐ray revealed mediastinal widening. [shmabstracts.com]
- Abdominal Fullness
He was treated for presumed irritable bowel syndrome, but his symptoms progressed to early satiety and abdominal fullness. He subsequently developed dysphagia, hemoptysis, and left groin pain. A chest X‐ray revealed mediastinal widening. [shmabstracts.com]
Eyes
- Eye Pain
Visual acuity in right eye was 20/20 and left eye was 20/800. [article.sapub.org]
Skin
- Subcutaneous Nodule
(c) Highly atypical cells with prominent nucleoli, binucleation and hyperchromasia (Wright, ×250) Click here to view With the diagnosis of subcutaneous metastatic choriocarcinoma, the nodule was excised which confirmed the cytological diagnosis [Figure [ijpmonline.org]
The patient subsequently developed several clustered erythematous-violaceous firm subcutaneous nodules without ulceration or other epidermal changes on the zygoma, with a larger nodule on the anterior neck and right posterior shoulder. [ncbi.nlm.nih.gov]
- Subcutaneous Mass
Two cases of males with subcutaneous masses as the first clinical sign of testicular choriocarcinoma are reported. The urine and serum human chorionic gonadotropin (hCG) test confirmed high level hCG from male choriocarcinoma. [ingentaconnect.com]
Psychiatrical
- Flat Affect
On physical examination, the patient had a flat affect, was slow to respond, and was acting unusual. [ncbi.nlm.nih.gov]
Neurologic
- Altered Mental Status
Magnetic resonance imaging (MRI) of the brain was ultimately performed for questionable altered mental status and revealed a small enhancing lesion [Figure 1] c. Figure 1: Testicular choriocarcinoma. Preoperative imaging. [urologyannals.com]
Urogenital
- Testicular Mass
In order to be able to treat these patients appropriately, a provider must recognize characteristic features of choriocarcinoma including elevated human chorionic gonadotropin in a young man with testicular mass; the astute clinician should also know [mayoclinic.pure.elsevier.com]
The histopathological assessment of the biopsied tissue, in combination with elevated serum β-HCG levels and presentation of testicular mass, indicated primary testicular choriocarcinoma with cutaneous and systemic metastasis. [ncbi.nlm.nih.gov]
Testicular ultrasound confirmed a left testicular mass. [acgcasereports.gi.org]
Although chemotherapy may result in disappearance of the testicular mass, orchiectomy is always indicated for accurate diagnosis. [article.sapub.org]
Unlike other testicular tumors, the most common symptom is related to metatasis rather than a testicular mass. Hemoptysis (coughing up blood) and back pain. Pure tumors are extremely uncommon with most tumors part of a mixed germ cell neoplasm. [humpath.com]
Workup
Therefore, serum markers for germ cell tumors should be sent as part of the initial workup for men in this age range presenting with metastatic disease. [surgicalneurologyint.com]
Postdiagnostic workup of an NSGCT includes chest/abdominal/pelvic computed tomography, repeat bHCG, LDH, and AFP levels, and brain MRI if indicated. [urologyannals.com]
He was sent to his primary care physician for a physical exam and a coagulability workup. The physical exam failed to provide any additional information, and the coagulability workup was negative. [retinalphysician.com]
Review Topic QID: 106375 5 No further workup, instruct patient to return if symptomatic M1 Select Answer to see Preferred Response PREFERRED RESPONSE 2 Sorry, this question is for PEAK Premium Subscribers only ARTICLES (4) VIDEOS (1) Topic COMMENTS (12 [medbullets.com]
After detailed history and physical examination, his metastatic workup was done. [jpma.org.pk]
X-Ray
- Atelectasis
Eight of them had extensive pulmonary metastases, three patients had hilar lymphadenopathy, and three others had bulky mediastinal adenopathy with atelectasis and pleural effusion. [frontiersin.org]
Treatment
Choriocarcinoma is a unique and aggressive germ cell malignancy, and these patients require early aggressive treatment to improve their chance of survival. [mayoclinic.pure.elsevier.com]
Treatment options include orchiectomy +/- combination chemotherapy. choriocarcinoma testicular germ cell tumors Promoted articles (advertising) [radiopaedia.org]
Treatment Outcome Treatment Approaches Without a Reduced-Dose Intensity During Induction Chemotherapy There is no effective preventive precaution against the choriocarcinoma syndrome. [frontiersin.org]
Alternative treatment Complementary treatments can decrease stress, reduce the side effects of cancer treatment, and help patients feel more in control. [encyclopedia.com]
Prognosis
Pure tumors have a worse prognosis than other testicular germ cell neoplasms. [humpath.com]
While 5-year overall survival and cure for this population is greater than 95 %, choriocarcinoma is an aggressive subtype of this disease with far worse prognosis—5-year survival for choriocarcinoma is less than 80 %. [mayoclinic.pure.elsevier.com]
Choriocarcinoma produces high levels of β-hCG, with levels > 50,000 mIU/ml conferring a particularly poor prognosis [ 9 ]. [ncbi.nlm.nih.gov]
Etiology
Etiology and epidemiology Choriocarcinoma of the placenta during pregnancy is preceded by: hydatidiform mole (50% of cases) spontaneous abortion (20% of cases) ectopic pregnancy (2% of cases) normal term pregnancy (20-30% of cases) hyperemesis gravidarum [ipfs.io]
(Etiology) The cause of Choriocarcinoma of the Testis is unknown. [dovemed.com]
Testicular tumors: epidemiologic, etiologic and pathologic features. Cancer 1973 ; 32 : 1186 – 201. 4. Zondek, B. Versuch einer biologischen (hormonalen) diagnostik beim malignen hodentumor. Chirug 1930 ; 2 : 1072 – 80. 5. [cambridge.org]
In patients with wide-spread tumoral disease and gastrointestinal hemorrhage, endoscopic management should be individualized according to personal and clinical characteristics, in order to obtain etiological information on the hemorrhage, a histological [scielo.isciii.es]
Etiology Risk factors Cryptorchidism (increased risk for germ cell tumors ) [4] Contralateral testicular cancer Germ cell neoplasia in situ (GCNIS) Family history of testicular cancer Klinefelter syndrome, Down syndrome (increased risk for germ cell tumors [amboss.com]
Epidemiology
[…] background. large multinucleated cells with smudged nuclear chromatin (syncytiotrophoblast) syncytiotrophoblasts form a "cap" around clusters of cytotrophoblasts hemorrhagic and necrotic foci residual scar as the only evidence of prior existence of the tumor Epidemiology [humpath.com]
[…] more common in Hispanics compared to Asian and black populations in the US References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
The epidemiology of testicular cancer in young adults. Am J Epidemiol 1980 ; 112 : 232 – 46. 2. Wingo, PA, Tong, T, Bolden, S. Cancer statistics, 1995. CA Cancer J Clin 1995 ; 45 : 8 – 30. 3. Mostofi, FK. [cambridge.org]
[…] trophoblast cells Identical tumors arise in placenta, ovary, mediastinum and abdomen (from sequestered cell rests) Essential features Hemorrhagic mass Early metastases Three cell types: syncytiotrophoblast, cytotrophoblast, intermediate trophoblast Epidemiology [pathologyoutlines.com]
National Cancer Institute – Surveillance, Epidemiology and End Results Program. Available from: https://www.seer.cancer.gov/statfacts/html/testis.html. [Last retrieved on 2017 Nov 28]. 5. Reilley MJ, Pagliaro LC. [urologyannals.com]
Pathophysiology
It brings together the pathophysiology of disease with detailed clinical guidance on diagnosis and management for the full range of childhood cancers, including aspects important in optimal supportive care. [books.google.de]
Epidemiology : usually develop after the age of 4 Pathophysiology : produces ↑↑ amounts of testosterone and a small amount of estrogen, progesterone, and corticosteroids → testosterone excess causes precocious puberty in males (and masculinization in [amboss.com]
Pathophysiology and Etiology Choriocarcinoma recapitulates placental tissue development. [emedicine.medscape.com]
Pathophysiology The exact pathogenesis of choriocarcinoma syndrome is currently unknown. [frontiersin.org]
Prevention
Prevention It’s not possible to prevent testicular cancer since most of the risk factors (young age, undescended testicles, being white, etc.) cannot be changed or controlled. [urmc.rochester.edu]
Treatment Outcome Treatment Approaches Without a Reduced-Dose Intensity During Induction Chemotherapy There is no effective preventive precaution against the choriocarcinoma syndrome. [frontiersin.org]
Prevention There is no known means of prevention. However, early detection of the symptoms and prompt medical treatment can improve the odds of survival. KEY TERMS Biopsy — A sample of an organ taken to look for abnormalities. [encyclopedia.com]
Prevention The primary prevention of choriocarcinoma is the early detection of hydatidiform mole to employ early removal and management of the condition. [cancerwall.com]
Prevention There is no known means of prevention. However, early detection of the symptoms and prompt medical treatment can improve the odds of survival. Key terms Biopsy — A sample of an organ taken to look for abnormalities. [medical-dictionary.thefreedictionary.com]