Beta-human chorionic gonadotropin expression in recurrent and metastatic giant cell tumors of bone: a potential mimicker of germ cell tumor.
Giant cell tumors of bone (GCTs) are generally benign, locally aggressive neoplasms that rarely metastasize. The beta subunit of human chorionic gonadotropin (beta-hCG) is expressed in syncytiotrophoblasts and several nongynecologic neoplasms but has not been described in GCT. At our institution, we observed cases of elevated beta-hCG in patients with GCT leading to diagnostic difficulty and in one case, concern for metastatic choriocarcinoma. This study aims to determine the frequency of beta-hCG expression in GCT and any relationship to clinical aggressiveness. We evaluated tissue expression of beta-hCG by immunohistochemistry with 58% of cases staining for beta-hCG. Additionally, 2 of 11 patients with available serum and/or urine beta-hCG measurements demonstrated elevated beta-hCG due to tumor. It is important to be aware of beta-hCG expression by GCT and the potential for elevated urine and serum beta-hCG levels in patients with GCT so as to avoid misdiagnosis of pregnancy or gestational trophoblastic disease.
University of Washington, Seattle, WA, USA.
Margaret E
ME
Lawless
University of Washington, Seattle, WA, USA.
George
G
Jour
University of Washington, Seattle, WA, USA.
Benjamin L
BL
Hoch
University of Washington, Seattle, WA, USA mararend@uw.edu.
Mara H
MH
Rendi
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis*; D012008:Recurrence; D055815:Young Adult
D018997:Chorionic Gonadotropin, beta Subunit, Human
beta-human chorionic gonadotropin; choriocarcinoma; giant cell tumor of bone