Clinical Report: Molecular and Clinicopathological Features of Primary Pulmonary Choriocarcinoma

Background

Primary pulmonary choriocarcinoma (PPC) is an exceptionally rare and aggressive non-gestational trophoblastic malignancy, often diagnosed late due to nonspecific clinical features. The lack of established treatment protocols and the poor response to conventional chemotherapy contribute to the high mortality associated with this disease.

Data Highlights

No numerical or trial data is available in the source material.

Key Findings

• A 61-year-old male patient with PPC presented with brain metastases and received a multimodal treatment approach.
• Targeted next-generation sequencing revealed alterations in TP53, STK11, KEAP1, and SMARCA4.
• The patient experienced prolonged extracranial disease control with a second-line immunotherapy-based regimen.
• A systematic review identified 45 previously reported PPC cases, underscoring the rarity and aggressive nature of the disease.
• PPC may be clinically and molecularly distinct from gestational choriocarcinoma.

Clinical Implications

The findings suggest that PPC requires a tailored treatment approach due to its distinct biological behavior compared to gestational choriocarcinoma. Clinicians should consider the potential role of immunotherapy in managing PPC, particularly in cases with advanced disease.

Conclusion

This case report and literature review highlight the challenges in diagnosing and treating PPC, emphasizing the need for further research to establish effective treatment protocols.

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