Primary mediastinal choriocarcinoma in a male patient
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Choriocarcinoma is a malignant germ cell neoplasm. It can exhibit in a gonadal site or, rarely, in extra-gonadal sites. Primary mediastinal choriocarcinoma can occur in both male and female in second and third decades of their life, but it is more common in male. The most common symptoms are cough, chest pain and gynecomastia. Plasma chorionic gonadotrophin (?-hCG), which is used as a tumor marker for diagnosis, staging and monitoring of the treatment response. Chemotherapy can achieve response if the case diagnosed early and receive the proper treatment earlier. BEP regimen is the standard first line chemotherapy, unless there is no contraindication specially for the presence of lung disease (Bleomycin) or kidney disease (cisplatin). We describe here a case of a 22-year-old heavy smoker Saudi male for more than 10 years, who was referred to us as a case of advanced pulmonary choriocarcinoma which confirmed by pathology and tumor marker. Our patient was admitted to ICU initially due to shortness of breath. The diagnosis was confirmed as a case of primary mediastinal choriocarcinoma. It could not be treated by surgery due to bad general condition of the patient with severe difficulty in breating requiring respiratory support and ICU care. The chemotherapy was started by VeIP Protocol for one cycle but due to no subjective response as well as the presence of same high level ?-hCG, the chemotherapy was changed to TIP Protocol. On the last day of chemotherapy, the patient started to complain about increasing tachypnea and tachycardia. He was transfered to ICU and was was intubated there. Although there was a significant decrease in his ?-hCG level, but unfortunately the patient died with multi-organ failure....
Dr. R●●i K●●●●●a and 3 others like this