Clinical Report: Primary Hepatic Carcinosarcoma with Ectopic β-hCG Production

Overview

This case study presents a rare instance of primary hepatic carcinosarcoma in a 47-year-old woman, characterized by ectopic β-hCG production and a paraneoplastic leukemoid reaction.

Background

Primary hepatic carcinosarcoma is an exceptionally rare and aggressive malignancy, often presenting diagnostic challenges due to nonspecific clinical and imaging findings. Ectopic β-hCG production and paraneoplastic leukemoid reactions are uncommon in solid tumors, complicating the clinical picture and potentially delaying diagnosis.

Data Highlights

No numerical or trial data provided in the source material.

Key Findings

• The patient presented with abnormal vaginal bleeding and elevated serum β-hCG levels.
• Diagnostic curettage revealed no evidence of pregnancy or trophoblastic disease.
• Marked leukocytosis was noted, with a peak white blood cell count of 97.05 × 10⁹/L.
• Imaging showed a rapidly enlarging mass in the right hepatic lobe with necrosis and vascular involvement.
• Histopathology confirmed poorly differentiated primary hepatic carcinosarcoma with β-hCG expression.
• Postoperative levels of β-hCG, white blood cells, and PIVKA-II fell markedly, indicating a paraneoplastic relationship.

Clinical Implications

Persistent elevation of β-hCG and marked leukocytosis should prompt consideration of underlying malignancies when imaging reveals a liver mass.

Conclusion

This case highlights the presentation of primary hepatic malignancies in patients with unexplained elevated β-hCG and leukocytosis.

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