Case report: elevated serum beta human chorionic gonadotropin in a woman with osteosarcoma.
Human chorionic gonadotropin is a glycoprotein hormone normally synthesized by placental syncytiotrophoblast cells. It also is secreted by gestational trophoblastic tumors, gonadal tumors, and even various nongonadal tumors, including bone and soft tissue sarcomas, as a paraneoplastic syndrome. The literature contains one case report of beta human chorionic gonadotropin production from a primary bone sarcoma occurring in a male patient. We report a woman of childbearing age who presented with a distal femur lytic lesion, clinical symptoms suggestive of pregnancy, and elevated serum beta human chorionic gonadotropin. Although the clinical diagnosis of a sarcoma was never in doubt, we present this case to emphasize a need to exclude pregnancy in women of childbearing age to avoid delay in biopsy and subsequent management. Positive immunohistochemical staining of the biopsy specimen established the tumor cells as the source of beta human chorionic gonadotropin.
Tuy
Benjamin E
BE
Division of Musculoskeletal Oncology, Department of Orthopaedics, University of Medicine and Dentistry-New Jersey Medical School, 140 Bergen Street, ACC Building, Suite D1610, Newark, NJ, 07103, USA. tuybe@umdnj.edu
Obafemi
Abimbola A
AA
Beebe
Kathleen S
KS
Patterson
Francis R
FR
D000328:Adult; D000671:Amputation, Surgical; D001707:Biopsy, Needle; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005266:Femoral Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D012516:Osteosarcoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D011258:Pregnancy Tests; D015854:Up-Regulation
D018997:Chorionic Gonadotropin, beta Subunit, Human