Advertisement
Correspondence| Volume 220, P138-139, January 2018

Increased human Chorionic Gonadotropin levels five years before diagnosis of an ovarian dysgerminoma

Published:November 10, 2017DOI:https://doi.org/10.1016/j.ejogrb.2017.11.008
      A 35 year-old nulliparous white woman was referred to the Department of Obstetrics and Gynecology at the University of Bari in July 2007 with a 6 weeks’ history of amenorrhea and increased level of serum human Chorionic Gonadotropin 125 IU/ml. Transvaginal ultrasound revealed the presence of a 2 × 2 cm right adnexal mass and diagnosis of ectopic pregnancy was placed. HCG level dropped in the next days to 38 and remained stable for the next two months. Diagnosis of persistent trophoblastic disease was made and the patient received 3 cycles of metothrexate (1 mg/sqm on day 1-3-5-7 with folinic acid rescue) but h-CG levels remained still stable (31 UI/ml). Pelvic ultrasound, total body CT scan, MRI of the pelvis, D&C were all negative. Diagnostic laparoscopy was performed but no pathologic finding was found. Blood samples revealed nohyperglycosilated hCG which is specific to trophoblastic disease.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Neven P.
        • Iles R.K.
        • Lee C.L.
        • Hudson C.N.
        • Shepherd J.H.
        • Chard T.
        Urinary chorionic gonadotropin subunits and beta-core in nonpregnant women. A study of benign and malignant gynecologic disorders.
        Cancer. 1993; 71: 4124-4130
        • Sun Z.
        • Yang J.
        • Guo L.J.
        Ovarian non-small cell neuroendocrine carcinoma associated with increased HCG beta.
        Clin Pathol. 2012; 65: 375-376
        • Demirtas E.
        • Krishnamurthy S.
        • Tulandi T.
        Elevated serum beta-human chorionic gonadotropin in nonpregnant conditions.
        Obstet Gynecol Surv. 2007; 62: 675-689
        • Murugaesu N.
        • Schmid P.
        • Dancey G.
        • Agarwal R.
        • Holden L.
        • McNeish I.
        • et al.
        Malignant ovarian germ cell tumors: identification of novel prognostic markers and long-term outcome after multimodality treatment.
        J Clin Oncol. 2006; 24: 4862-4866
        • Palmieri C.
        • Dhillon T.
        • Fisher R.A.
        • Young A.M.
        • Short D.
        • Mitchell H.
        • et al.
        Management and outcome of healthy women with a persistently elevated beta-hCG.
        Gynecol Oncol. 2007; 106: 35-43