title: Primary hepatic choriocarcinoma in a 49-year-old man: report of a case.
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.
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sekine
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Hyodo
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kojima
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Meguro
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Lefor
authors.affiliation: Ryosuke Sekine, Department of Emergency Medicine, Ibaraki Prefectural Central Hospital, Ibaraki 309-1793, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Hirota
mesh_terms: D001344:Autopsy; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D031954:Choriocarcinoma, Non-gestational / Q000737:chemistry / Q000150:complications / Q000556:secondary*; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000150:complications / Q000473:pathology*; D008175:Lung Neoplasms / Q000737:chemistry / Q000150:complications / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor
keywords: Fludeoxyglucose-positron emission tomography; Hepatic choriocarcinoma; Human chorionic gonadotropin; Liver biopsy; Male