open access

Vol 23, No 2 (2020)
Clinical vignette
Published online: 2020-06-18
Submitted: 2020-04-09
Accepted: 2020-05-22
Get Citation

Primary nasal-ethmoid choriocarcinoma detected by 18F-FDG PET/CT: a rare tumor with complete remission

Maria Gazzilli, Domenico Albano, Laura Ardighieri, Francesco Bertagna, Raffaele Giubbini
DOI: 10.5603/NMR.a2020.0012
·
Nucl. Med. Rev 2020;23(2):105-107.

open access

Vol 23, No 2 (2020)
Clinical vignette
Published online: 2020-06-18
Submitted: 2020-04-09
Accepted: 2020-05-22

Abstract

Choriocarcinoma is a highly malignant and rare tumor characterized by secretion of the beta-subunit-of-humanchoriogonadotropin (β-HCG). We report a case of primary nasal choriocarcinoma with good response to chemotherapy. A 36-years-old woman gravida 0 and with history of 4 spontaneous abortion, in December 2018 referred to Otorhinolaryngology Department for repeated episodes of epistaxis. Cervical Magnetic Resonance Imaging (MRI) revealed a tumor mass involving right nasal cavity, right ethmoid, sphenoidal and maxillary sinuses. For a differential diagnosis between metastatic gestational choriocarcinoma and primary choriocarcinoma in January 2019 she underwent 18Fluorine-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG-PET/CT) scan that demonstrated intense uptake only in the nasal-ethmoid tumor mass showed by MRI. This was suggestive of primary nasal-ethmoid choriocarcinoma she received 3 courses of BEP – regimen and after β-HCG was reduced to 500 mIU/mL and 18F-FDG-PET/CT scan showed a decreased uptake in tumor mass but the appearance of a new uptake in cervical lymph node which was analysed and reported as metastatic localization of choriocarcinoma. Therefore she was treated with 2 cycles of TIP-regimen. Subsequents 18F-FDG-PET/CT and MRI showed a complete tumor remission. This case proved the fundamental role of PET/CT to make diagnosis of primitive choriocarcinoma and to exclude the hypothesis of distant metastasis.

Abstract

Choriocarcinoma is a highly malignant and rare tumor characterized by secretion of the beta-subunit-of-humanchoriogonadotropin (β-HCG). We report a case of primary nasal choriocarcinoma with good response to chemotherapy. A 36-years-old woman gravida 0 and with history of 4 spontaneous abortion, in December 2018 referred to Otorhinolaryngology Department for repeated episodes of epistaxis. Cervical Magnetic Resonance Imaging (MRI) revealed a tumor mass involving right nasal cavity, right ethmoid, sphenoidal and maxillary sinuses. For a differential diagnosis between metastatic gestational choriocarcinoma and primary choriocarcinoma in January 2019 she underwent 18Fluorine-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG-PET/CT) scan that demonstrated intense uptake only in the nasal-ethmoid tumor mass showed by MRI. This was suggestive of primary nasal-ethmoid choriocarcinoma she received 3 courses of BEP – regimen and after β-HCG was reduced to 500 mIU/mL and 18F-FDG-PET/CT scan showed a decreased uptake in tumor mass but the appearance of a new uptake in cervical lymph node which was analysed and reported as metastatic localization of choriocarcinoma. Therefore she was treated with 2 cycles of TIP-regimen. Subsequents 18F-FDG-PET/CT and MRI showed a complete tumor remission. This case proved the fundamental role of PET/CT to make diagnosis of primitive choriocarcinoma and to exclude the hypothesis of distant metastasis.

Get Citation

Keywords

choriocarcinoma; nasal-ethmoidal; PET/CT

About this article
Title

Primary nasal-ethmoid choriocarcinoma detected by 18F-FDG PET/CT: a rare tumor with complete remission

Journal

Nuclear Medicine Review

Issue

Vol 23, No 2 (2020)

Pages

105-107

Published online

2020-06-18

DOI

10.5603/NMR.a2020.0012

Bibliographic record

Nucl. Med. Rev 2020;23(2):105-107.

Keywords

choriocarcinoma
nasal-ethmoidal
PET/CT

Authors

Maria Gazzilli
Domenico Albano
Laura Ardighieri
Francesco Bertagna
Raffaele Giubbini

References (8)
  1. Zhou HY, Nguyen JK, Ganesan S, et al. Choriocarcinoma of the adrenal gland: A case report. Int J Surg Case Rep. 2015; 6C: 92–94.
  2. Gurzu S, Copotoiu C, Tugui A, et al. Primary gastric choriocarcinoma - a rare and aggressive tumor with multilineage differentiation: A case report. World J Clin Cases. 2019; 7(14): 1837–1843.
  3. Bell DM, Porras G, Tortoledo ME, et al. Primary sinonasal choriocarcinoma. Ann Diagn Pathol. 2009; 13(2): 96–100.
  4. Tariq M, Kalan A. Metastatic choniocarcinoma of the nasal cavity-presenting as intractable expistaxis. Indian J Otolaryngol Head Neck Surg. 2004; 56(3): 220–222.
  5. Stockton L, Green E, Kaur B, et al. Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature. Case Rep Oncol. 2018; 11(1): 151–158.
  6. Sato S, Yamamoto E, Niimi K, et al. The efficacy and toxicity of 4-day chemotherapy with methotrexate, etoposide and actinomycin D in patients with choriocarcinoma and high-risk gestational trophoblastic neoplasia. Int J Clin Oncol. 2019.
  7. Kurobe M, Kawai K, Oikawa T, et al. Paclitaxel, ifosfamide, and cisplatin (TIP) as salvage and consolidation chemotherapy for advanced germ cell tumor. J Cancer Res Clin Oncol. 2015; 141(1): 127–133.
  8. Motzer RJ, Sheinfeld J, Mazumdar M, et al. Paclitaxel, ifosfamide, and cisplatin second-line therapy for patients with relapsed testicular germ cell cancer. J Clin Oncol. 2000; 18(12): 2413–2418.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl