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Oncology
β-hCG secreting uterine PEComa
  1. Patrick Murphy1,2,
  2. Karla Machlab2,
  3. Shahd Almohsen1,3,
  4. Jennifer Fratesi4 and
  5. Geoffrey Watson2,5
  1. 1Department of Laboratory Medicine and Pathobiology, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
  2. 2Medical Oncology, Mount Sinai Hospital PLM, Toronto, Ontario, Canada
  3. 3Pathology, Mount Sinai Hospital PLM, Toronto, Ontario, Canada
  4. 4Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
  5. 5Department of Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
  1. Correspondence to Dr Geoffrey Watson; geoffrey.watson{at}uhn.ca

Abstract

A postmenopausal female patient presented with vaginal bleeding. Initial bloodwork revealed an elevated serum beta human chorionic gonadotropin level (β-hCG). Pelvic MRI identified a complex heterogeneous uterine mass with central necrosis. She underwent total abdominal hysterectomy with bilateral saplingo-oopherectomy. Pathology reported a malignant perivascular epithelioid cell tumour (PEComa). Postoperatively, her β-hCG level returned to normal. β-hCG secreting sarcomas are extremely rare, and to our knowledge, there has only been one previously reported case of a β-hCG secreting PEComa. Based on the limited literature, these tumours may have a worse prognosis. The role of β-hCG as a marker of treatment response and disease activity is unclear. Additional studies are required to further ascertain its role as a predictive and prognostic biomarker.

  • Cancer intervention
  • Oncology
  • Gynecological cancer
  • Pathology

https://doi.org/10.1136/bcr-2023-256641

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    Footnotes

    • Twitter @GeoffAWatson1

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: PM, KM, SA, JF and GW. The following authors gave final approval of the manuscript: PM, KM, SA, JF and GW.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.