男性肺原发性绒毛膜癌1例报道附文献复习

Primary pulmonary choriocarcinoma in men(with a case report and a review of literatures)

目的提高对男性肺原发性绒毛膜癌的认识。方法对1例经开胸肺活检确诊为男性肺原发性绒毛膜癌患者的临床资料进行分析,并结合文献进行复习。结果男性肺原发性绒毛膜癌是一种恶性程度很高的肿瘤,包含合体滋养层细胞。其病因尚不清楚,可能有原发部位实质细胞直接转化而来。临床表现为咯血、胸痛、咳嗽,常伴有女性化体征,血和尿绒毛膜促性腺激素(β-HCG)明显升高。如不治疗,患者可在短期内死亡,预后差。结论遇到咯血、胸痛、咳嗽等症状,影像学发现肺部结节状阴影且血或尿β-HCG升高应想到该疾病的可能,应尽早给予治疗包括手术和化疗相结合。

Objective To improve the early diagnosis of primary pulmonary choriocarcinoma in men and to discuss the effective therapeutic means. Methods One male patient with primary pulmonary choriocarcinoma confirmed by exploratory thoracotomy and biopsy, and relevant literatures were reviewed. Results Primary pulmonary choriocarcinoma in men , which contained syncytiotrophoblastic cells, was one of the highly malignant tumors. The pathogenesis was uncertain, probably it directly transformed from primary essential cells. The clinical manifestations included hemoptysis, chest pain, cough, signs of feminization, and high level of serum or urine β - human chorionic gonadotropin （β - HCG）. If patients were untreated, it progressed rapidly and had a poor prognosis. Conclusion Primary pulmonary choriocarcinoma in men should be considered if patients had symptoms described above. The treatment containing surgery and chemotherapy should be given as early as possible once the disease is confirmed.