Metastatic choriocarcinoma to the lumbar spine: Case report and review of literature

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Abstract

Background:

There are few cases of choriocarcinoma metastases to the spine that have been reported. Most occurrences are in women with the gestational form of the tumor, and these now exhibit a very high remission rate with chemotherapeutic treatment, typically circumventing the need for spinal surgery.

Case Description:

In an effort to better understand treatment options for those rare instances when choriocarcinoma does find its way into the spine, we have synthesized a comprehensive literature review on the clinical cases of choriocarcinoma spinal metastases. We also describe our unique experience and decision-making involving the first reported case of surgical treatment of non-gestational choriocarcinoma spinal metastases in a male patient.

Conclusion:

Spinal surgery has a limited role in metastatic choriocarcinoma, but there is the potential for improving neurologic decline even in the rare and aggressive male variant of this disease.

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Most cited references 25

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Gestational trophoblastic disease.

Elizabeth Garner, P Goldstein, Colleen M Feltmate … (2007)

Hydatidiform mole, a disorder of fertilization, comprises complete and partial molar pregnancy. The pathologic and clinical features of complete and partial mole are well-described. Because of earlier diagnosis, however, the clinical presentation of complete molar pregnancy has significantly changed in recent years. The earlier diagnosis of complete mole is associated with more subtle pathologic findings than later molar pregnancy. The use of immunohistochemical techniques for the detection of maternally imprinted genes as ancillary testing in the diagnosis of complete and partial mole is therefore increasing. Although most molar pregnancies are sporadic, a familial syndrome of recurrent hydatidiform mole has been described. Further research will hopefully lead to identification of the gene defect responsible for this uncommon syndrome. Fortunately, patients with molar pregnancies can generally anticipate normal future reproduction. Close hCG follow-up after molar pregnancy is required to rule out development of postmolar gestational trophoblastic neoplasia. Recent studies suggest that a shorter period of postmolar follow-up may be reasonable for patients with both complete and partial molar pregnancy.

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Is Open Access

Testicular Cancer

(2016)

Sami Rabadi, Faris Ayyat, Moheb Milad Department of Urology, Aramco Dhahran Health Center, Dhahran, Saudi Arabia Fourteen cases of testicular cancer were diagnosed and treated at Dhahran Health Center between January 1981 and December 1988. Nine seminomas and five non-seminomatous testicular cancer (NSTC). Three patients had cryptorchidism; one unilateral and two bilateral. For seminomas the median age was 38 years (range 27-59). Eight had clinical stage I, and one stage IID. All stage I patients were treated with radical orchiectomy and postoperative lymph node irradiation. With a median follow up of 24 months (6-75 months range) all had no evidence of disease recurrence (NED). The stage IID patients died of his disease 34 months from his orchiectomy. He was non-compliant. Of the five NSTC patients, three adults and two children. Their ages were 54, 36, 34, 2 1/2 and 1 1/2 years. The stages were IIIA L3, IVCH+, pathologic IIA, clinical IIA and unknown respectively. All were treated with radical orchiectomy and cisplatinum based combination chemotherapy. Adequate follow up duration is available for four patients (72, 28, 12 and 60 months). All remained NED. Although the number of patients is small, our treatment results are excellent and suggest that testicular cancer even when advanced is a highly treatable solid tumor. Presented at the: 5th Saudi Urological Conference King Fahd Military Medical Complex 22-23 March 1989

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Testicular cancer incidence trends in the USA (1975-2004): plateau or shifting racial paradigm?

B X Foldi, Jordan D. Ward, Gbadebo O Ogungbade … (2008)

It has been reported that the incidence of testicular cancer has plateaued in some parts of the USA, especially among non-Hispanic Whites in Los Angeles. Temporal trends analysis was conducted over three decades to assess the evidence for such a plateau, and to examine whether the incidence of testicular cancer remains stable across racial/ethnic groups. This study also investigated the influence of age at diagnosis on the incidence of testicular cancer. Population-based temporal trends analysis. Using the Surveillance Epidemiology and End Results (SEER), 16,580 newly diagnosed cases of testicular cancer in males aged 15-49 years were identified between 1975 and 2004. Incidence rates were examined by calculating the age-adjusted rates and their 95% confidence interval (CI) for age at diagnosis, SEER areas and race for the year of diagnosis. The percentage change and annual percentage change were examined for trends. The incidence of testicular cancer is continuing to increase among US males, despite the plateau of the 1990s. Between 1975 and 2004, the age-adjusted incidence rate for males aged 15-49 years increased from 2.9 (1975) to 5.1 (2004) per 100,000. The trends indicated a percentage change of 71.9% and a statistically significant annual percentage change of 1.6% (95%CI 1.3-2.0; P<0.05). Although the incidence of testicular cancer in Blacks remained strikingly low (0.3-1.4 per 100,000), the highest annual percentage change was observed among this group (2.3%, 95%CI 0.8-3.9; P<0.05 for trends). The rates were intermediate among Asians/Pacific Islanders and American Indian and Alaska Natives (0.7-2.9 per 100,000), with a percentage change of 117.3% and a statistically significant annual percentage change of 1.5% (95%CI 0.3-2.7; P<0.05 for trends). The highest rates were reported among Whites (3.2-6.3 per 100,000), with a percentage change of 90.4% and a statistically significant annual percentage change of 2.0% (95%CI 1.6-2.3; P<0.05). The most common age at diagnosis was 30-34 years, while the lowest rates were reported in those aged 15-19 years. Likewise, incidence rates varied by SEER areas, with predominantly White states representing areas associated with the highest reported rates of testicular cancer. Overall, the incidence of testicular cancer continues to plateau in the USA, while racial variance persists. Black males demonstrate the greatest increase in annual percentage change. Further studies are needed to examine the recent increase among Black males and the potential determinants.

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Author and article information

Contributors

Jesse Skoch

Kelly Kobylanski

Jeffrey M. Rice

Ali A. Baaj

Journal

Journal ID (nlm-ta): Surg Neurol Int

Journal ID (iso-abbrev): Surg Neurol Int

Journal ID (publisher-id): SNI

Title: Surgical Neurology International

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2229-5097

ISSN (Electronic): 2152-7806

Publication date Collection: 2014

Publication date (Electronic): 21 November 2014

Volume: 5

Electronic Location Identifier: 161

Affiliations

[1]Department of Surgery, Division of Neurological Surgery, The University of Arizona Medical Center, Tucson, Arizona, USA

[1 ]Department of Pathology, The University of Arizona Medical Center, Tucson, Arizona, USA

Author notes

[* ]Corresponding Author

Article

Publisher ID: SNI-5-161

DOI: 10.4103/2152-7806.145205

PMC ID: 4258720

PubMed ID: 25525554

SO-VID: b1be4394-aa14-465f-87b4-82b9cb2be9fb

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 18 July 2014

Date accepted : 24 September 2014

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Metastatic choriocarcinoma to the lumbar spine: Case report and review of literature

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Abstract

Background:

Case Description:

Conclusion:

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ScienceOpen Clinical Case Reports Collection

Most cited references 25

Gestational trophoblastic disease.

Testicular Cancer

Testicular cancer incidence trends in the USA (1975-2004): plateau or shifting racial paradigm?

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