Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Moran CA, Suster S (1997) Primary mediastinal choriocarcinomas: a clinicopathologic and immunohistochemical study of eight cases. Am J Surg Pathol 21:1007–1012

    Article  CAS  PubMed  Google Scholar 

  2. Greenwood SM, Goodman JR, Schneider G et al (1971) Choriocarcinoma in a man. Am J Med 51:416–422

    Article  CAS  PubMed  Google Scholar 

  3. Arai M, Oka K, Nihei T et al (2001) Primary hepatic choriocarcinoma—a case report. Hepatogastroenterology 48:424–426

    CAS  PubMed  Google Scholar 

  4. Fernández Alonso J, Sáez C et al (1992) Primary pure choriocarcinoma of the liver. Pathol Res Pract 188:375–377

    PubMed  Google Scholar 

  5. van der Hoef M, Niggli FK, Willi UV et al (2004) Solitary infantile choriocarcinoma of the liver: MRI findings. Pediatr Radiol 34:820–823

    Article  PubMed  Google Scholar 

  6. Theegarten D, Reinacher A, Graeven U et al (1998) Mixed malignant germ cell tumour of the liver. Virchows Arch 433:93–96

    Article  CAS  PubMed  Google Scholar 

  7. Candes FP, Ajinkya MS (1987) Primary mediastinal choriocarcinoma (case report). J Postgrad Med 33:219–221

    CAS  PubMed  Google Scholar 

  8. Yamashita S, Ohyama C, Nakagawa H et al (2002) Primary choriocarcinoma in the posterior mediastinum. J Urol 167:1789

    Article  PubMed  Google Scholar 

  9. McKenney JK, Heerema-McKenney A, Rouse RV (2007) Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations. Adv Anat Pathol 14:69–92

    Article  PubMed  Google Scholar 

  10. Vegh GL, Szigetvári I, Soltesz I et al (2008) Primary pulmonary choriocarcinoma: a case report. J Reprod Med 53:369–372

    PubMed  Google Scholar 

  11. Bell DM, Porras G, Tortoledo ME et al (2009) Primary sinonasal choriocarcinoma. Ann Diagn Pathol 13:96–100

    Article  PubMed  Google Scholar 

  12. Minei S, Matsui T, Obinata D et al (2008) Primary choriocarcinoma of the urinary bladder. Hinyokika Kiyo 54:293–296

    PubMed  Google Scholar 

  13. Kobayashi A, Hasebe T, Endo Y et al (2005) Primary gastric choriocarcinoma: two case reports and a pooled analysis of 53 cases. Gastric Cancer 8:178–185

    Article  PubMed  Google Scholar 

  14. Yun EJ, Chung JY, Han HS (2005) Primary mediastinal choriocarcinoma. Int J Gynaecol Obstet 88:158–159

    Article  CAS  PubMed  Google Scholar 

  15. Dehner LP (1990) Germ cell tumors of the mediastinum. Semin Diagn Pathol 7:266–284

    CAS  PubMed  Google Scholar 

  16. Dulmet EM, Macchiarini P, Suc B et al (1993) Germ cell tumors of the mediastinum. Cancer 72:1894–1901

    Article  CAS  PubMed  Google Scholar 

  17. Lack EE, Weinstein HJ, Welch KJ (1985) Mediastinal germ cell tumors in childhood: a clinical and pathological study of 21 cases. J Thorac Cardiovasc Surg 89:826–835

    CAS  PubMed  Google Scholar 

  18. Sato K, Takeuchi H, Kubota T (2009) Pathology of intracranial germ cell tumors. Prog Neurol Surg 23:59–75

    Article  PubMed  Google Scholar 

  19. Ragam A, Apichai S, Radhakrishnan A et al (2008) Extragonadal choriocarcinoma in ulcerative colitis. J Clin Oncol 26:5813–5814

    Article  PubMed  Google Scholar 

  20. Kathuria S, Jablokov VR (1987) Primary choriocarcinoma of liver with immunohistochemical study and review of the literature. J Surg Oncol 34:39–42

    Article  CAS  PubMed  Google Scholar 

  21. Kersh RC, Constable WC, Hahn SS et al (1990) Primary malignant extragonadal germ cell tumors: an analysis of the effect of radiotherapy. Cancer 65:2681–2685

    Article  CAS  PubMed  Google Scholar 

  22. Jacobsen GK, Barlebo H, Olsen J et al (1984) Testicular germ cell tumours in Denmark 1976–1980. Pathology of 1058 consecutive cases. Acta Radiol Oncol 23:239–247

    Article  Google Scholar 

  23. Powell S, Hendry WF, Peckham MJ (1983) Occult germ-cell testicular tumours. Br J Urol 55:440–444

    Article  CAS  PubMed  Google Scholar 

  24. Yoon JM, Burns RC, Malogolowkin MH et al (2007) Treatment of infantile choriocarcinoma of the liver. Pediatr Blood Cancer 49:99–102

    Article  PubMed  Google Scholar 

  25. Balzer BL, Ulbright TM (2006) Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases. Am J Surg Pathol 30:858–865

    Article  PubMed  Google Scholar 

  26. Wong NA, D'Costa H, Barry RE et al (1998) Primary yolk sac tumour of the liver in adulthood. J Clin Pathol 51:939–940

    Article  CAS  PubMed  Google Scholar 

  27. Lenci I, Tariciotti L, Baiocchi L et al (2008) Primary yolk sac tumor of the liver: incidental finding in a patient transplanted for hepatocellular carcinoma. Transpl Int 21:598–601

    Article  PubMed  Google Scholar 

  28. Toumi N, Chaumette-Plankaert MT, Cherqui D et al (2004) Germ cell tumors. Case 3. Primary yolk sac tumor of the liver. J Clin Oncol 22:1756–1758

    Article  PubMed  Google Scholar 

  29. Verma M, Agarwal S, Mohta A (2003) Primary mixed germ cell tumour of the liver—a case report. Indian J Pathol Microbiol 46:658–659

    PubMed  Google Scholar 

  30. Kim SN, Chi JG, Kim YW et al (1993) Neonatal choriocarcinoma of liver. Pediatr Pathol 13:723–730

    Article  CAS  PubMed  Google Scholar 

  31. Verbeek W, Schulten HJ, Sperling M et al (2004) Rectal adenocarcinoma with choriocarcinomatous differentiation: clinical and genetic aspects. Hum Pathol 35:1427–1430

    Article  CAS  PubMed  Google Scholar 

  32. Granier G, Marty-Double C (2007) Gastrointestinal adenocarcinomas with a choriocarcinomatous component: 2 cases and a review of 120 cases in the literature. Gastroenterol Clin Biol 31:854–857

    Article  PubMed  Google Scholar 

  33. Yamamoto S, Tanaka H, Takeo H et al (2006) Primary pulmonary choriocarcinoma combined with adenocarcinoma. Pathol Int 56:402–407

    Article  PubMed  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Department of Pathology, The Chinese PLA General Hospital, Fuxing Road 28#, Beijing, 100853, China

    Huaiyin Shi, Lixin Wei, Lu Sun & Aitao Guo

  2. Department of Pathology and Immunology, School of Medicine, Washington University, Saint Louis, MO, USA

    Dengfeng Cao

Authors
  1. Huaiyin Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dengfeng Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lixin Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lu Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aitao Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Huaiyin Shi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shi, H., Cao, D., Wei, L. et al. Primary choriocarcinoma of the liver: a clinicopathological study of five cases in males. Virchows Arch 456, 65–70 (2010). https://doi.org/10.1007/s00428-009-0864-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-009-0864-1

Keywords

Search

Navigation