Secretion of hCG/β-hCG by squamous cell carcinoma of the lung in a 31-year-old female smoker

Abstract

We describe a rare case of pulmonary squamous cell carcinoma secreting human chorionic gonadotropin (hCG) and its β-subunit (β-hCG) in a young female smoker. A 31-year-old mother of one child had been suffering from dysfunctional uterine bleeding for about 1 year. Pelvic examinations and abdominal ultrasonography yielded no abnormal findings and no signs of pregnancy. She developed a pain in the right chest and a huge (12 x 10 cm) squamous cell carcinoma was diagnosed in the right lower lobe. The serum hCG and β-hCG levels were high: hCG 5611 mlU/ml (normal upper limit 0.7 mlU/ml), β-hCG 12 238 mlU/ml (normal upper limit 0.5 mlU/ml). The patient underwent right lower lobectomy and systematic lymph node dissection. Microscopic study showed a poorly differentiated squamous cell carcinoma. The pathological stage was T2N0M0, stage IB. Immunohistochemical staining of the tumor was strongly positive for hCG. The serum hCG level returned to normal 1 month after the operation, while an additional 2 months were necessary for the β-hCG level to normalize. Dysfunctional uterine bleeding disappeared and the patient is doing well, with no signs of recurrence, 9 months after the resection.