A 22-year-old Chinese man presented in pulmonary crisis with massive bilateral pulmonary metastases from choriocarcinoma. Because of a diagnostic error, he was initially treated with medroxyprogesterone and responded with a marked lowering of serum luteinizing hormone and lysis of his fever – suggesting that progestins may be useful in the treatment of choriocarcinoma. When his true diagnosis was established, he was treated with conventional poly chemotherapy. He had persistant elevations of serum estrogen and testosterone levels throughout his course, a feature not previously reported in choriocarcinoma in males. Although he was given very large doses of chemotherapy, and achieved a partial remission, he suffered no bone marrow toxicity. It is suggested that the elevated levels of circulating testosterone protected him from bone marrow toxicity. Androgens may be an important adjuvant in the chemotherapy of cancer. Elevated titres of LH (but not sex steroids) were found in his cerebral spinal fluid when he developed cerebral metastases, suggesting that the malignant trophoblast secretes chorionic gonadotropin (but not sex steroids) which, in turn, stimulates the secretion of sex steroids in target glands. The patient ultimately succumbed from a perforation in the cardia of his stomach.

Keywords:
Choriocarcinoma in male, Progesterone treatment, Elevated testosterone levels, Hormone levels in CSF (cerebrospinal fluid)
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© 1974 S. Karger AG, Basel
1974
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