Choriocarcinomatous Features Research Articles

A case of pulmonary adenocarcinoma with choriocarcinomatous features

A case of pulmonary adenocarcinoma with choriocarcinomatous features

Breast Carcinoma withChoriocarcinomatous Features

Breast cancer with choriocarcinomatous features is a rare variant of breast malignancy with poor prognosis and poor response to treatment. The tumour cells express high expression of human chorionic gonadotropin in cancer cells such as multinucleated syncytioblast like giant cells. The histogenetic origin of these cells is unknown but the most reliable theory involves a metaplastic process. The frequently found metaplastic changes are squamous, spindle cells, or osseous, chon­droid, or matrix production. Non-gestational choriocarcinomatous differentiation is extremely rare in breast neoplasms. Choriocarcinomatous differentiation has also been described in tumour arising from many organs including lung, rectum, colon, stoamach and urinary bladder. Most of the patient with choriocarcinomatous features presents with high grade disease, that is exhibiting an aggressive clinical course with an overall survival of less than a year. In this case report, the history, physical examination, laboratory findings and pathological findings of breast carcinoma in a 40year old woman are described. The patient underwent lumpectomy of left breast. Microscopically the tumour was reported as Invasive ductal carcinoma with choriocarcinomatous features. Nottingham grade III, ER- Negative, PR- Negative, HER2-neu Negative . Histology of choriocarcinoma in breast is distinctly unusual. Before making a confirmatory diagnosis of breast cancer with choriocarcinomatous features a possibility of metastatic choriocarcinoma to the breast should always be ruled out because of its poor prognosis.

The Significant Antitumor Activity of Nivolumab in Lung Adenocarcinoma with Choriocarcinomatous Features

We report the case of a 60-year-old Japanese man with a metastatic brain tumor that caused ataxia. As a consequence of resection of a cerebellar tumor, the tumor was diagnosed as a poorly differentiated adenocarcinoma with choriocarcinomatous features. The patient underwent bronchoscopy, leading to a diagnosis of the same histology as the brain tumor. After the administration of first-line chemotherapy and maintenance therapy due to progressive disease, he was given nivolumab and obtained a partial response; however, 11-months later, computed tomography showed tumor progression. Our experience suggests that nivolumab has strong activity, even in patients with a rare form of lung cancer.

Metaplastic carcinoma of the breast: an immunohistochemical study.

BackgroundMetaplastic breast carcinoma is a rare entity of breast cancer expressing epithelial and/or mesenchymal tissue within the same tumor. The aim of this study is to evaluate the clinicopathological features of metaplastic breast carcinoma and to confirm the triple negative, basal-like and/or luminal phenotype of this type of tumor by using immunohistochemical staining.MethodsSeven cases of MBC were evaluated for clinico-pathological features including follow up data. Cases were studied immunohistochemically by CK-Pan, Vimentin, ER, PR, HER2, basal markers (CK5/6, p63, EGFR, SMA and S-100), luminal cytokeratins (CK8, CK18 and CK19), markers for syncytial cells (β-HCG and PLAP), as well as prognostic markers (p53, ki-67 and calretinin).ResultsThe mean age of the patients was 36 years. Three cases showed choriocarcinomatous features. All of our cases were negative for ER, PR and HER2. Six out of the 7 cases showed basal-like differentiation by demonstrating positivity with at least one of the basal/myoepithelial markers. Also 6 out of the 7 cases expressed luminal type cytokeratins (CK8, CK18 and/or CK19). P53 was positive in 3 cases, ki-67 was strongly expressed in only one case, while calretinin was expressed in 6 cases.ConclusionMetaplastic breast carcinoma presents in our population at a younger age group than other international studies. All cases are categorized immunohistochemically under the triple negative group of breast cancer and 86% of them exhibited basal-like and luminal phenotype. Majority of cases developed local recurrence and distant metastasis in a relatively short period of time.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1101289295115804

Breast Carcinoma with Choriocarcinomatous Features: A Case Report

Nongestational choriocarcinoma differentiation is extremely rare in breast neoplasms. It is characterized by tumor cells similar to chorionic trophoblastic cells, which react with human placental lactogen and human chorionic gonadotropin (hCG). A 56-year-old woman presented with a palpable right breast mass without past history of trophoblastic tumors. An F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan revealed one focus with low accumulation of FDG in the right breast (maximum standardized uptake value, 1.98). The patient underwent a right mastectomy and biopsy of sentinel nodes. Microscopically, the tumor was a typical invasive ductal carcinoma with multiple foci of choriocarcinoma features. Immunohistochemistry showed that the tumor cells resembling choriocarcinoma were positive for hCG antibody, but negative for HER2/neu, estrogen receptor, and progesterone receptor. A pathologic diagnosis of breast carcinoma with choriocarcinomatous features was made. To our knowledge, this is the first report of invasive carcinoma with choriocarcinomatous features and an unusual finding of low accumulation in an F-18 FDG PET/CT scan in Korea.

Carcinoma of the Breast With Choriocarcinomatous Features

Choriocarcinomatous differentiation has been described in tumors arising from many organs including lung, rectum, colon, stomach, bladder, and rarely breast. Mammary carcinoma with choriocarcinomatous features is a rare variant of breast metaplastic carcinoma characterized by malignant cells morphologically resembling choriocarcinoma cells in which reactivity with human placental lactogen and human chorionic gonadotropin can be demonstrated by immunohistochemistry. The characteristic syncytiotrophoblast-like giant cells seen in these neoplasms are more commonly associated with moderately to poorly differentiated carcinomas with or without a clear-cut mesenchymal component. Most of the reported cases have behaved very aggressively. The reason for this poor prognosis remains unclear. Because of the small number of cases, special treatment protocols have not been developed and these patients are treated surgically and with the standard chemotherapeutic agents available for other types of carcinoma of the breast. Pathologically, these tumors must be distinguished from metastatic choriocarcinoma to the breast.

Breast Carcinoma with Choriocarcinomatous Features

Breast Carcinoma with Choriocarcinomatous Features

Carcinoma da mama com diferenciação coriocarcinomatosa

This report describes the case of a 45 year-old patient with breast carcinoma characterized by choriocarcinomatous features, presence of bizarre anaplastic cells with areas of necrosis and multinucleated giant cells. The immuno-histochemical analysis showed positivity for chromogranin and β-HCG. The tumor size was 5.7 cm at the largest axis and it was refractory to initial neo-adjuvant treatment. Mastectomy was performed and after microscopic and immuno-histochemical examination it was diagnosed as carcinoma with choriocarcinomatous features. These lesions are rare and liable to synthesize hormonal substances not specific to breast tissue. Its diagnosis is highly significant to the therapeutic and prognostic approach insofar as these lesions are potentially aggressive.

Anaplastic Large Cell Carcinoma with Choriocarcinomatous Features Metastatic to the Brain

An example of anaplastic large cell carcinoma with choriocarcinoma-like differentiation metastatic to the brain is presented. Correlation between serum hCG levels and immunohistochemistry staining is essential for proper diagnosis. (The J Histotechnol 31:137, 2008)Submitted April 30, 2008; accepted with revisions June 30, 2008

Anaplastic Large Cell Carcinoma with Choriocarcinomatous Features Metastatic to the Brain

Abstract An example of anaplastic large cell carcinoma with choriocarcinoma-like differentiation metastatic to the brain is presented. Correlation between serum hCG levels and immunohistochemistry staining is essential for proper diagnosis. (The J Histotechnol 31:137, 2008)Submitted April 30, 2008; accepted with revisions June 30, 2008

Sarcomatoid Urothelial Carcinoma with Choriocarcinomatous Features: First Report of an Unusual Case

A 61-year-old man presented with gross hematuria and a polypoid right lateral bladder mass. The tumor was composed of conventional urothelial carcinoma with sarcomatoid and choriocarcinomatous features, both positive for epithelial markers (pancytokeratin, AE1/AE3, and CAM 5.2). In addition, choriocarcinomatous tumor cells were positive for beta human chorionic gonadotropin and placental alkaline phosphatase. Treatments included surgery, chemotherapy, and radiation therapy. The clinical course was aggressive, with liver, lung, and distant lymph node metastases and a postdiagnosis survival of 6 months. This is the first report, to our knowledge, indicating both sarcomatoid and choriocarcinomatous features in a conventional urothelial carcinoma of the bladder.

Fine-needle aspiration biopsy of a case of breast carcinoma with choriocarcinomatous features

Breast disease is of great concern to patients and health care providers alike. Malignancies of the breast and their various presentations can pose tremendous challenges with respect to early diagnosis and effective treatment. Carcinoma of the breast may appear in several forms and produce one or more ectopic substances. Breast carcinomas that display choriocarcinomatous differentiation and produce human chorionic gonadotropin are very rare. Less than a dozen such cases have been described in the medical literature to date. We report a case of breast carcinoma with choriocarcinomatous features, which is the first to show immunohistochemical evidence of the expression of both estrogen receptor and progesterone receptor. We also discuss the cytopathologic aspects observed and conduct a literature review.

Urothelial carcinoma of the renal pelvis with choriocarcinomatous features: Genetic evidence of clonal evolution

Urothelial carcinoma with choriocarcinomatous features is a rare malignancy arising in the urinary bladder or renal pelvis. We report the case of a 60-year-old man with a biphasic neoplasm of the right kidney composed of papillary urothelial carcinoma and choriocarcinoma. Widespread hepatic and pulmonary metastases with choriocarcinomatous features were found on autopsy 6 weeks after initial diagnosis. Chromosomal analysis revealed a close genetic relationship between the papillary urothelial and choriocarcinomatous tumor components, documenting for the first time that choriocarcinoma of the renal pelvis results from clonal evolution of urothelial carcinoma with acquisition of trophoblastic differentiation. HUM PATHOL 33:1234-1237. Copyright 2002, Elsevier Science (USA). All rights reserved.

Urothelial carcinoma of the bladder with choriocarcinomatous differentiation: A report of two cases and review of the literature

Urothelial carcinoma with choriocarcinomatous differentiation is a rare morphologic variant of bladder cancer, and only a limited number of cases have been reported. We present two cases of bladder cancer with choriocarcinomatous features that had different outcomes. The clinical and pathologic features are reviewed to better understand the natural history of this malignant neoplasm. The histologic features of the tumor were compared between the two cases. Immunoperoxidase staining was performed on the tumor cells with polyclonal beta human chorionic gonadotropin (β-hCG) antibody. A comprehensive literature search revealed an additional 25 confirmed cases, which are summarized in this presentation. Of the 27 patients, only 3 patients were reported to be alive without evidence of disease after treatment. The majority presented with invasive tumors and had a mean survival of 12 months after diagnosis. Chemotherapy, radiation, or radical surgery in advanced stages did not improve survival. Choriocarcinoma in visceral organs usually occurs with high-grade carcinomas and we believe that it is best considered dedifferentiation of the tumor. Urothelial carcinoma with choriocarcinomatous differentiation is an extremely aggressive tumor, and in the rare patient with early stage disease and normal to moderately elevated serum β-hCG levels, long-term survival can be achieved with radical surgery.

Choriocarcinomatous features in mammary mucoid carcinoma

Choriocarcinomatous features in mammary mucoid carcinoma