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Virchows Archiv

, Volume 456, Issue 1, pp 65–70 | Cite as

Primary choriocarcinoma of the liver: a clinicopathological study of five cases in males

  • Huaiyin ShiEmail author
  • Dengfeng Cao
  • Lixin Wei
  • Lu Sun
  • Aitao Guo
Original Article

Abstract

Primary choriocarcinomas of the liver are rare. Previous reported cases were mostly in infants with only rare adult cases. Here, we presented five adult cases. The patients were all males, with an average age of 41.6 years (from 36 to 48 years). Clinical presentations included right upper abdominal pain or abdominal distension. All patients presented with a large hepatic mass on ultrasonography that measured 11 cm on average in the greatest diameter. Elevated serum human chorionic gonadotropin (HCG) levels were noted in all cases. At presentation, the tumor was confined to the liver in two patients and therefore surgically resected. The other three patients presented with extrahepatic metastases on imaging study and therefore only received chemotherapy. All five patients died from the tumor within 2 to 8 months. Autopsy was performed for all five cases. The autopsy confirmed that the choriocarcinoma was confined to the liver in two surgically resected cases. The other three patients had metastatic choriocarcinoma in the lung (two patients), peritoneum (one patient), adrenal glands (one patient), and brain (one patient). None of the patients had any evidence of a testicular tumor or scar after examination of the entirely submitted testes. No tumor was observed in central nervous system, mediastinum, or other organs other than described above. Grossly, the primary tumors were large, soft, hemorrhagic, and with foci of necrosis. Histologically, the tumors were composed of mononucleated trophoblastic cells with round nuclei, clear cytoplasm, and prominent nucleoli admixed with large, multinucleated syncytiotrophoblastic cells. Immunohistochemically, tumor cells were strongly positive for keratin, HCG, and focally positive for human placental lactogen. Ki-67 proliferation index was high (mean 75%) in the mononucleated trophoblastic cells. Our series is the largest one to document primary hepatic choriocarcinoma in adults. Although these tumors are rare, they behave in a very aggressive fashion.

Keywords

Choriocarcinoma Extragonadal germ cell tumors Liver 

Notes

Acknowledgment

The author thanks Xin Song, Wei Chen, Enping Bai, Shiming Zan, Chao Guo, and Xia Tian for their excellent technical assistance.

Conflict of interest statement

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Huaiyin Shi
    • 1
    Email author
  • Dengfeng Cao
    • 2
  • Lixin Wei
    • 1
  • Lu Sun
    • 1
  • Aitao Guo
    • 1
  1. 1.Department of PathologyThe Chinese PLA General HospitalBeijingChina
  2. 2.Department of Pathology and Immunology, School of MedicineWashington UniversitySaint LouisUSA

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