Elevated beta human chorionic gonadotropin in a non-pregnant female diagnosed with anal squamous cell carcinoma
Introduction Elevated serum beta human chorionic gonadotrophin (β-hCG) in a female normally indicates pregnancy or possibly, gestational trophoblastic disease or ovarian germ cell tumours. Expression of β-hCG has been demonstrated in cervical and endometrial carcinoma and other non-germ cell tumours...
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| Veröffentlicht in: | Journal of oncology pharmacy practice 2020-07, Vol.26 (5), p.1266-1269 |
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| creator | Pokharel, Khageshwor Gilbar, Peter J Mansfield, Scott K Nair, Lekshmi M So, Albertina |
| description | Introduction
Elevated serum beta human chorionic gonadotrophin (β-hCG) in a female normally indicates pregnancy or possibly, gestational trophoblastic disease or ovarian germ cell tumours. Expression of β-hCG has been demonstrated in cervical and endometrial carcinoma and other non-germ cell tumours of the ovary, vulva, breast, prostate, lung, colon, oral/facial tissue and stomach.
Case report
We report a 43-year-old premenopausal woman with p16 positive squamous cell anal cancer. Pre-treatment urinary screening was positive for β-hCG (218 IU/L), which was confirmed on serum and expressed in the tumour. Pelvic ultrasound ruled out pregnancy. Cervical cytology detected human papilloma virus p16 infection and a potential squamous intraepithelial lesion.
Management and outcome: She received definitive chemoradiation (Mitomycin/5-fluorouracil) for six weeks. β-hCG, taken four weeks post completion, had returned to normal levels ( |
| doi_str_mv | 10.1177/1078155219893428 |
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Elevated serum beta human chorionic gonadotrophin (β-hCG) in a female normally indicates pregnancy or possibly, gestational trophoblastic disease or ovarian germ cell tumours. Expression of β-hCG has been demonstrated in cervical and endometrial carcinoma and other non-germ cell tumours of the ovary, vulva, breast, prostate, lung, colon, oral/facial tissue and stomach.
Case report
We report a 43-year-old premenopausal woman with p16 positive squamous cell anal cancer. Pre-treatment urinary screening was positive for β-hCG (218 IU/L), which was confirmed on serum and expressed in the tumour. Pelvic ultrasound ruled out pregnancy. Cervical cytology detected human papilloma virus p16 infection and a potential squamous intraepithelial lesion.
Management and outcome: She received definitive chemoradiation (Mitomycin/5-fluorouracil) for six weeks. β-hCG, taken four weeks post completion, had returned to normal levels (<2 IU/L).
Discussion
Cases of elevated serum β-hCG are documented in different cancers including breast, gastric, lung, ovarian and renal cell. In our case, the elevated β-hCG is probably ectopic excretion by the squamous cell carcinoma tumour in the anus. While this has never been reported previously in the anus, it is likely due to the documented risk of development of precancerous as well as cancerous anal and cervical lesions through human papilloma virus infection. Raised levels of β-hCG have been reported in cervical cancers. Other possible causes of β-hCG elevation were excluded. Following treatment, her β-hCG level returned to normal strengthening the hypothesis that β-hCG elevation was due to the anal carcinoma. In conclusion, unexplained ectopic secretion of β-hCG may be the first sign of a primary malignancy.</description><identifier>ISSN: 1078-1552</identifier><identifier>EISSN: 1477-092X</identifier><identifier>DOI: 10.1177/1078155219893428</identifier><identifier>PMID: 31840564</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>5-Fluorouracil ; Anal cancer ; Anus ; Breast ; Cervical cancer ; Cervix ; Chemoradiotherapy ; Chorionic gonadotropin ; Colon ; Colorectal cancer ; Cytology ; Endometrial cancer ; Endometrium ; Gonadotropins ; Human papillomavirus ; Lungs ; Malignancy ; Mitomycin ; Ovaries ; Pituitary (anterior) ; Pregnancy ; Prostate ; Renal cell carcinoma ; Squamous cell carcinoma ; Trophoblastic disease ; Tumors ; Ultrasound ; Uterine cancer ; Vulva</subject><ispartof>Journal of oncology pharmacy practice, 2020-07, Vol.26 (5), p.1266-1269</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-500cd4ade3259ee3e564ea2d94532ea69ca15669d8c967b22b66e37bea119ee53</citedby><cites>FETCH-LOGICAL-c365t-500cd4ade3259ee3e564ea2d94532ea69ca15669d8c967b22b66e37bea119ee53</cites><orcidid>0000-0001-7748-1891</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1078155219893428$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1078155219893428$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31840564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pokharel, Khageshwor</creatorcontrib><creatorcontrib>Gilbar, Peter J</creatorcontrib><creatorcontrib>Mansfield, Scott K</creatorcontrib><creatorcontrib>Nair, Lekshmi M</creatorcontrib><creatorcontrib>So, Albertina</creatorcontrib><title>Elevated beta human chorionic gonadotropin in a non-pregnant female diagnosed with anal squamous cell carcinoma</title><title>Journal of oncology pharmacy practice</title><addtitle>J Oncol Pharm Pract</addtitle><description>Introduction
Elevated serum beta human chorionic gonadotrophin (β-hCG) in a female normally indicates pregnancy or possibly, gestational trophoblastic disease or ovarian germ cell tumours. Expression of β-hCG has been demonstrated in cervical and endometrial carcinoma and other non-germ cell tumours of the ovary, vulva, breast, prostate, lung, colon, oral/facial tissue and stomach.
Case report
We report a 43-year-old premenopausal woman with p16 positive squamous cell anal cancer. Pre-treatment urinary screening was positive for β-hCG (218 IU/L), which was confirmed on serum and expressed in the tumour. Pelvic ultrasound ruled out pregnancy. Cervical cytology detected human papilloma virus p16 infection and a potential squamous intraepithelial lesion.
Management and outcome: She received definitive chemoradiation (Mitomycin/5-fluorouracil) for six weeks. β-hCG, taken four weeks post completion, had returned to normal levels (<2 IU/L).
Discussion
Cases of elevated serum β-hCG are documented in different cancers including breast, gastric, lung, ovarian and renal cell. In our case, the elevated β-hCG is probably ectopic excretion by the squamous cell carcinoma tumour in the anus. While this has never been reported previously in the anus, it is likely due to the documented risk of development of precancerous as well as cancerous anal and cervical lesions through human papilloma virus infection. Raised levels of β-hCG have been reported in cervical cancers. Other possible causes of β-hCG elevation were excluded. Following treatment, her β-hCG level returned to normal strengthening the hypothesis that β-hCG elevation was due to the anal carcinoma. In conclusion, unexplained ectopic secretion of β-hCG may be the first sign of a primary malignancy.</description><subject>5-Fluorouracil</subject><subject>Anal cancer</subject><subject>Anus</subject><subject>Breast</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Chemoradiotherapy</subject><subject>Chorionic gonadotropin</subject><subject>Colon</subject><subject>Colorectal cancer</subject><subject>Cytology</subject><subject>Endometrial cancer</subject><subject>Endometrium</subject><subject>Gonadotropins</subject><subject>Human papillomavirus</subject><subject>Lungs</subject><subject>Malignancy</subject><subject>Mitomycin</subject><subject>Ovaries</subject><subject>Pituitary (anterior)</subject><subject>Pregnancy</subject><subject>Prostate</subject><subject>Renal cell carcinoma</subject><subject>Squamous cell carcinoma</subject><subject>Trophoblastic disease</subject><subject>Tumors</subject><subject>Ultrasound</subject><subject>Uterine cancer</subject><subject>Vulva</subject><issn>1078-1552</issn><issn>1477-092X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kctLxDAQxoMouq7ePUnAi5dqHk3SHkXWByx4UfBWpunsbqVN1qRV_O_Nsj5AEAIJfL_55psMISecXXBuzCVnpuBKCV4WpcxFsUMmPDcmY6V43k3vJGcb_YAcxvjCGCuMKPbJgeRFzpTOJ8TPOnyDARta4wB0NfbgqF350HrXWrr0Dho_BL9uHU0HqPMuWwdcOnADXWAPHdKmhaXzMZm8t8OKgoOOxtcRej9GarHrqIVgW-d7OCJ7C-giHn_dU_J0M3u8vsvmD7f311fzzEqthkwxZpscGpRClYgSU1gE0ZS5kgJBlxa40rpsCltqUwtRa43S1AicJ17JKTnf-q6Dfx0xDlXfxk0UcJhSVUIKI41Umif07A_64seQZkhULmSuC8lkotiWssHHGHBRrUPbQ_ioOKs2y6j-LiOVnH4Zj3WPzU_B9-8nINsCEZb42_Vfw0_Ha5H9</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Pokharel, Khageshwor</creator><creator>Gilbar, Peter J</creator><creator>Mansfield, Scott K</creator><creator>Nair, Lekshmi M</creator><creator>So, Albertina</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7748-1891</orcidid></search><sort><creationdate>20200701</creationdate><title>Elevated beta human chorionic gonadotropin in a non-pregnant female diagnosed with anal squamous cell carcinoma</title><author>Pokharel, Khageshwor ; Gilbar, Peter J ; Mansfield, Scott K ; Nair, Lekshmi M ; So, Albertina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-500cd4ade3259ee3e564ea2d94532ea69ca15669d8c967b22b66e37bea119ee53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>5-Fluorouracil</topic><topic>Anal cancer</topic><topic>Anus</topic><topic>Breast</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Chemoradiotherapy</topic><topic>Chorionic gonadotropin</topic><topic>Colon</topic><topic>Colorectal cancer</topic><topic>Cytology</topic><topic>Endometrial cancer</topic><topic>Endometrium</topic><topic>Gonadotropins</topic><topic>Human papillomavirus</topic><topic>Lungs</topic><topic>Malignancy</topic><topic>Mitomycin</topic><topic>Ovaries</topic><topic>Pituitary (anterior)</topic><topic>Pregnancy</topic><topic>Prostate</topic><topic>Renal cell carcinoma</topic><topic>Squamous cell carcinoma</topic><topic>Trophoblastic disease</topic><topic>Tumors</topic><topic>Ultrasound</topic><topic>Uterine cancer</topic><topic>Vulva</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pokharel, Khageshwor</creatorcontrib><creatorcontrib>Gilbar, Peter J</creatorcontrib><creatorcontrib>Mansfield, Scott K</creatorcontrib><creatorcontrib>Nair, Lekshmi M</creatorcontrib><creatorcontrib>So, Albertina</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of oncology pharmacy practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pokharel, Khageshwor</au><au>Gilbar, Peter J</au><au>Mansfield, Scott K</au><au>Nair, Lekshmi M</au><au>So, Albertina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elevated beta human chorionic gonadotropin in a non-pregnant female diagnosed with anal squamous cell carcinoma</atitle><jtitle>Journal of oncology pharmacy practice</jtitle><addtitle>J Oncol Pharm Pract</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>26</volume><issue>5</issue><spage>1266</spage><epage>1269</epage><pages>1266-1269</pages><issn>1078-1552</issn><eissn>1477-092X</eissn><abstract>Introduction
Elevated serum beta human chorionic gonadotrophin (β-hCG) in a female normally indicates pregnancy or possibly, gestational trophoblastic disease or ovarian germ cell tumours. Expression of β-hCG has been demonstrated in cervical and endometrial carcinoma and other non-germ cell tumours of the ovary, vulva, breast, prostate, lung, colon, oral/facial tissue and stomach.
Case report
We report a 43-year-old premenopausal woman with p16 positive squamous cell anal cancer. Pre-treatment urinary screening was positive for β-hCG (218 IU/L), which was confirmed on serum and expressed in the tumour. Pelvic ultrasound ruled out pregnancy. Cervical cytology detected human papilloma virus p16 infection and a potential squamous intraepithelial lesion.
Management and outcome: She received definitive chemoradiation (Mitomycin/5-fluorouracil) for six weeks. β-hCG, taken four weeks post completion, had returned to normal levels (<2 IU/L).
Discussion
Cases of elevated serum β-hCG are documented in different cancers including breast, gastric, lung, ovarian and renal cell. In our case, the elevated β-hCG is probably ectopic excretion by the squamous cell carcinoma tumour in the anus. While this has never been reported previously in the anus, it is likely due to the documented risk of development of precancerous as well as cancerous anal and cervical lesions through human papilloma virus infection. Raised levels of β-hCG have been reported in cervical cancers. Other possible causes of β-hCG elevation were excluded. Following treatment, her β-hCG level returned to normal strengthening the hypothesis that β-hCG elevation was due to the anal carcinoma. In conclusion, unexplained ectopic secretion of β-hCG may be the first sign of a primary malignancy.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31840564</pmid><doi>10.1177/1078155219893428</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0001-7748-1891</orcidid></addata></record> |
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| subjects | 5-Fluorouracil Anal cancer Anus Breast Cervical cancer Cervix Chemoradiotherapy Chorionic gonadotropin Colon Colorectal cancer Cytology Endometrial cancer Endometrium Gonadotropins Human papillomavirus Lungs Malignancy Mitomycin Ovaries Pituitary (anterior) Pregnancy Prostate Renal cell carcinoma Squamous cell carcinoma Trophoblastic disease Tumors Ultrasound Uterine cancer Vulva |
| title | Elevated beta human chorionic gonadotropin in a non-pregnant female diagnosed with anal squamous cell carcinoma |
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