title: A case study on the potential angiogenic effect of human chorionic gonadotropin hormone in rapid progression and spontaneous regression of metastatic renal cell carcinoma during pregnancy and after surgical abortion.
abstract: BACKGROUND
  Treatment possibilities of metastatic renal cell carcinoma (mRCC) have recently changed dramatically prolonging the overall survival of the patients. This kind of development brings new challenges for the care of mRCC.
  
  
  METHODS
  A 22 year-old female patient with translocation type mRCC, who previously had been treated for nearly 5 years, became pregnant during the treatment break period. Follow-up examinations revealed a dramatic clinical and radiological progression of mRCC in a few weeks therefore the pregnancy was terminated. A few days after surgical abortion, CT examination showed a significant spontaneous regression of the pulmonary metastases, and the volume of the largest manifestation decreased from ca. 30 to 3.5 cm(3) in a week. To understand the possible mechanism of this spectacular regression, estrogen, progesterone and luteinizing hormone receptors (ER, PGR and LHR, respectively) immuno-histochemistry assays were performed on the original surgery samples. Immuno-histochemistry showed negative ER, PGR and positive LHR status suggesting the possible angiogenic effect of human chorionic gonadotropin hormone (hCG) in the background.
  
  
  CONCLUSIONS
  We hypothesize that pregnancy may play a causal role in the progression of mRCC via the excess amount of hCG, however, more data are necessary to validate the present notions and the predictive role of LHR overexpression.
authors.affiliation: Institute of Oncotherapy, University of Pécs, H-7624, Édesanyák útja 17, Pécs, Hungary. mangellaszlo@gmail.com.
authors.forename: László
authors.initials: L
authors.lastname: Mangel
authors.affiliation: Department of Chemotherapy, National Institute of Oncology, Budapest, Hungary. szbirokriszta@gmail.com.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Bíró
authors.affiliation: Department of Radiology, University of Pécs, Pécs, Hungary. batyo@chello.hu.
authors.forename: István
authors.initials: I
authors.lastname: Battyáni
authors.affiliation: Clinic of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary. peter.gocze@aok.pte.hu.
authors.forename: Péter
authors.initials: P
authors.lastname: Göcze
authors.affiliation: Institute of Pathology, University of Pécs, Pécs, Hungary. ttamas64@hotmail.com.
authors.forename: Tamás
authors.initials: T
authors.lastname: Tornóczky
authors.affiliation: Institute of Pathology, University of Pécs, Pécs, Hungary. ke6100@gmail.com.
authors.forename: Endre
authors.initials: E
authors.lastname: Kálmán
mesh_terms: D000032:Abortion, Therapeutic; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D006063:Chorionic Gonadotropin / Q000502:physiology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D009365:Neoplasm Regression, Spontaneous; D009389:Neovascularization, Pathologic; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin