open access

Vol 23, No 2 (2020)
Clinical vignette
Submitted: 2020-04-09
Accepted: 2020-05-22
Published online: 2020-06-18
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Primary nasal-ethmoid choriocarcinoma detected by 18F-FDG PET/CT: a rare tumor with complete remission

Maria Gazzilli1, Domenico Albano1, Laura Ardighieri2, Francesco Bertagna1, Raffaele Giubbini1
·
Pubmed: 33007099
·
Nucl. Med. Rev 2020;23(2):105-107.
Affiliations
  1. Nuclear Medicine, University of Brescia, Spedali Civili Brescia, Brescia, Italy
  2. Department of Pathology ASST Spedali Civili, Brescia, Italy

open access

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

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.

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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)

Article type

Clinical vignette

Pages

105-107

Published online

2020-06-18

Page views

755

Article views/downloads

684

DOI

10.5603/NMR.a2020.0012

Pubmed

33007099

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)
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  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.

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