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Case Report
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Korean J Med. 2014;86(5):641-646. Published online May 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.5.641
- 50대 남자 환자에서 대세포 폐암으로 오인된 원발성 종격동 융모막암 1예
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김영신, 한치화, 정윤화, 정민영, 고성우, 윤경진, 정한희
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가톨릭대학교 의과대학 내과학교실
- A Case of Primary Mediastinal Choriocarcinoma Mimicking Large Cell Carcinoma of the Lung in a Male Patient in His 50s
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Young Shin Kim, Chi Wha Han, Yun Hwa Jung, Min Young Jeong, Seong Woo Go, Kyung Jin Yun, Han Hee Chung
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Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
- Corresponding author: Chi Wha Han ,Tel: +82-2-3779-2428, Fax: +82-2-780-3132, Email: cwhan@unitel.co.kr
- Received: July 23, 2013; Revised: September 17, 2013 Accepted: October 11, 2013.
- 남자에서 발생된 성선 외 융모막암은 매운 드문 종양으로 종격동에서 발생하는 경우 폐암이나 호지킨 림프종으로 오 인되기 쉽다. 특히 일반적인 나이를 비롯하여 전이 방식 등 생식세포암의 임상적 특징을 보이지 않는 경우와 경피적 침 생검에서 분화도가 좋지 않은 상피암 형태로 관찰되는 경우 진단이 지연될 수 있다. 저자들은 50대의 남자에서 경피적 생검 결과 대세포 폐암이 의심되어 절제술을 시행한 후 원 발성 종격동 융모막암으로 진단된 1예를 경험하였기에 교훈 적인 증례로 보고하는 바이다.
߽ɾ :원발성 종격동 융모막암종; 대세포 폐암
- Abstract
- Primary mediastinal choriocarcinoma is an extremely rare extragonadal germ cell malignancy. A 58-year-old male presented with a lung mass, which was incidentally discovered during a periodic medical checkup. Percutaneous needle biopsy showed poorly differentiated carcinoma with large pleomorphic morphology. After the patient underwent right upper lobectomy and lymphadenectomy, the final diagnosis was choriocarcinoma. The patient received four sequential cycles of BEP chemotherapy (bleomycin, etoposide, cisplatin). After completion of BEP chemotherapy, follow-up positron emission tomography (PET) showed a complete metabolic response. Although the mediastinum is one of the most common primary sites of extragonadal germ cell tumors, primary mediastinal choriocarcinoma is liable to be misdiagnosed as lung cancer or Hodgkin lymphoma. Notably, large cell carcinoma of the lung can be confused with choriocarcinoma even after percutaneous needle biopsy. We report a case of primary mediastinal choriocarcinoma mimicking large cell carcinoma of the lung in a male patient in his 50s. (Korean J Med 2014;86:641-646)
Keywords :Primary mediastinal choriocarcinoma, Large cell carcinoma
