When cancer patients suddenly have a positive pregnancy test

Abstract

We present the case of non-small cell lung cancer (NSCLC) in a 48-year-old woman with an active history of smoking. The patient initially presented to her general practitioner with a progressive swelling on the neck. Further investigations diagnosed a metastatic lung tumour, and palliative chemotherapy was started. After 5 months of treatment, by newly reported amenorrhoea, cautiously before a restaging CT scan of the abdomen, a pregnancy test was performed and was positive. Both the gynaecological examination and the hormonal panel yielded no signs of pregnancy. Immunohistochemically, staining of the tumour was strongly positive for β-subunit of human chorionic gonadotropin (β-hCG) suggesting that the tumour was responsible for high β-hCG levels.Paraneoplastic β-hCG secretion from adenocarcinomas is rare. In the literature, only a few such cases have been reported. Previous studies suggested that the ability to secrete β-hCG in tumours may correlate to some extent to chemoresistance and thus, to a worse prognosis.

Keywords: Lung cancer (oncology); Pathology.

Figure 1

CT of the thorax showing the tumour in the right upper pulmonary lobe. (A) Longitudinal section; (B) transverse section.

Figure 2

(A,B) Cytological examination from pericardial effusion with plenty of cell clusters from adenocarcinoma. Carcinoma cells positive for β-subunit of human chorionic gonadotropin