Retroperitoneal Leiomyosarcoma Associated with an Elevated β-HCGSerum Level Mimicking Extragonadal Germ Cell Tumor

[摘要] Patient.A 65-year-old man was admitted with a large primary retroperitonealtumor and an increased β-human chorionic gonadotropin (β-HCG) serum level. A germcell tumor was suspected; however, a computed tomography-guided biopsy failed to enabletumor classification. After two courses of chemotherapy, the β-HCG serum level had returnedto the normal level and a diagnostic laparotomy with incisional biopsy was performed.The immunohistochemical examination of the specimen identified the tumor as aretroperitoneal pleomorphic leiomyosarcoma.Discussion.Tumor markers play only a marginal role in the work-upof patients with soft tissue sarcomas. In men with suspected retroperitoneal sarcomas,however, the determination of germ cell tumor markers occasionally enables a preoperativedistinguishing of primary retroperitoneal germ cell tumors with considerable consequencesfor management. In this setting, a retroperitoneal tumor associated with a moderatelyelevated β-HCG is a diagnostic dilemma, and surgeons should be aware of the pitfallof a β-HCG-producing leiomyosarcoma in the differential diagnosis.

[学科分类] 肿瘤学