PDF(Pubmed)
Abstract：
Rare adrenal choriocarcinoma should be identified as gestational or nongestational choriocarcinoma because of their different treatment and prognosis. A 29-year-old parous women underwent curettage and right-oviduct resection successively due to irregular vaginal bleeding and positive human chorionic gonadotropin (HCG). Postoperative pathological examinations revealed no intrauterine and extrauterine pregnancy. After that, HCG continued to rise. A 7.6×10.3×11.0 cm mass was present in the left adrenal gland with an uneven inner density and a complete capsule by computed tomography (CT). A biopsy was performed on the mass, which showed us choriocarcinoma. Seven cycles of chemotherapy made her complete response and under supervision. Recurrent diagnosis was done after 3 months. The tumor specimen, the patient\'s blood, and her husband\'s blood were drawn for short tandem repeat (STR) analysis using polymerase chain reaction amplification kit. The genotype of the tumor cells was both maternal and patrilineal, which led to the diagnosis of adrenal gestational choriocarcinoma. The patient was scheduled for adrenalectomy and various chemotherapeutic interventions before and after operation. She achieved complete response and was being followed up again. STR analysis first aids in precise classification of this rare adrenal choriocarcinoma. We encourage using the method to analyze choriocarcinoma outside reproductive organs.
摘要：
由于罕见的肾上腺绒毛膜癌的治疗和预后不同，应将其鉴定为妊娠或非妊娠绒毛膜癌。由于不规则的阴道出血和人绒毛膜促性腺激素（HCG）阳性，一名29岁的产妇先后接受了刮宫和右输卵管切除术。术后病理检查未发现宫内及宫外孕。之后,HCG继续上升。左肾上腺存在7.6×10.3×11.0厘米的肿块，内部密度不均匀，计算机断层扫描（CT）显示完整的包膜。对肿块进行了活检，显示了绒毛膜癌。七个周期的化疗使她完全反应并在监督下。3个月后再次诊断。肿瘤标本,病人的血液，和她丈夫的血液进行短串联重复（STR）分析使用聚合酶链反应扩增试剂盒。肿瘤细胞的基因型是母体和父系，这导致了肾上腺妊娠绒毛膜癌的诊断。患者计划在手术前后进行肾上腺切除术和各种化疗干预。她获得了完整的回应，并再次受到跟进。STR分析首先有助于对这种罕见的肾上腺绒毛膜癌进行精确分类。我们鼓励运用该办法剖析生殖器官外面绒毛膜癌。
