Gonadotropin secreting giant cell carcinoma of the lung

A case report of a habitual smoker with pulmonary tuberculosis and carcinoma of the left upper lobe associated with gynecomastia is presented. After excision of the left upper lobe, the patient remained well for 21/2 years but then showed clinical evidence of recurrence and died 6 months later of carcinoma. He had gynecomastia and, during his terminal hospitalization, chorionic gonadotropin was identified in his urine. Postmortem studies revealed giant cell carcinoma of the left lower lobe with widespread metastasis. Assays of extracts from tumor tissue indicated high levels of gonadotropic activity. Morphologic manifestations of endocrinopathy were represented by gynecomastia, interstitial cell hyperplasia of the testes, and presence of “pregnancy‐like” cells in the anterior lobe of the pituitary gland. The mechanism whereby the gynecomastia is produced may be the release of estrogen following long‐term stimulation of the testes by gonadotropin. Atrophy of the seminiferous tubules due to antecedent mumps orchids was a predisposing factor that favored the severe hyperplasia of the interstitial cells.