Sekundäre Amenorrhö, subjektive Schwangerschaftszeichen und erhöhte Serum-hCG-Werte verursacht durch ein großzelliges Bronchialkarzinom

Ectopic production of hCG, especially of the free subunit β-hCG, is found to occur in a number of differing neoplasms. We describe the case of a 42-year old woman who presented with secondary amenorrhoea, subjective signs of pregnancy and an elevated level of serum hCG (maximum 109 IU/L). Computed tomography of the chest revealed two intrapulmonary round foci; a metastatic trophoblast tumour was therefore diagnosed first. Diagnostic abrasion and abdominal hysterectomy were performed but there was no evidence of trophoblastic tissue. Since serum hCG levels did not decrease after three courses of chemotherapy with methotrexate, thoracotomy and resection of both round foci were performed. Histological and immunohistochemical investigations showed a hCG-producing bronchogenic carcinoma. Postoperative serum hCG levels decreased and the clinical symptoms of the patient disappeared.