title: [A patient with very high serum level of human chorionic gonadotrophin; the diagnosis is not always a germ-cell tumour].
abstract: A 47-year-old man, who presented with dyspnoea, gynaecomasty, and aphasia due to an extensively metastasized malignancy, was transferred to the hospital for chemotherapy as a matter of urgency. Because of his severe clinical symptoms, the widespread presence of metastases on radiological examination, and a striking increase in serum human chorionic gonadotrophin (HCG), the patient was treated with bleomycin, etoposide, and cisplatin (BEP) for a suspected metastasized germ-cell tumour. Definitive histology, however, revealed not a germ-cell tumour, but instead a large-cell undifferentiated HCG-producing carcinoma of uncertain primary origin. Using this patient's history, ectopic HCG production by malignancies is described in more detail.
authors.affiliation: Afd. Geneeskundige Oncologie, VU Medisch Centrum, Amsterdam. jj.vandervliet@vumc.nl
authors.forename: H J J
authors.initials: HJ
authors.lastname: van der Vliet
authors.forename: P
authors.initials: P
authors.lastname: Lefesvre
authors.forename: C J
authors.initials: CJ
authors.lastname: van Groeningen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D006063:Chorionic Gonadotropin / Q000097:blood*; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D006063:Chorionic Gonadotropin