TY - JOUR
T1 - A non-pregnant woman with elevated beta-HCG
T2 - A case of para-neoplastic syndrome in ovarian cancer
AU - Goldstein, Jennifer
AU - Pandey, Prasamsa
AU - Fleming, Nicole
AU - Westin, Shannon
AU - Piha-Paul, Sarina
N1 - Publisher Copyright:
© 2016 The Authors
PY - 2016
Y1 - 2016
N2 - There is a broad range of possible diagnoses for an elevated beta human chorionic gonadotropin (β-hCG) in the absence of intrauterine or ectopic pregnancy. When women of child bearing potential undergo evaluation for clinical trial, it is often unclear what course of evaluation to take when a pregnancy test is positive. We describe the clinical course of a patient with widely metastatic mucinous ovarian carcinoma with metastasis to the peritoneum, lymph nodes and liver. The patient was found to have a mildly elevated β-hCG during initial evaluation for clinical trial. Extensive work up for ectopic pregnancy, trophoblastic disease, and phantom β-hCG were negative. The patient's β-hCG levels continued to rise until initiation of therapy. She was treated on a phase I protocol with restaging scans revealing a partial response. The β-hCG was retested and declined in conjunction with her response, consistent with paraneoplastic β-hCG. Here, we propose a decision making algorithm to evaluate a patient with an elevated β-hCG undergoing assessment for clinical trial.
AB - There is a broad range of possible diagnoses for an elevated beta human chorionic gonadotropin (β-hCG) in the absence of intrauterine or ectopic pregnancy. When women of child bearing potential undergo evaluation for clinical trial, it is often unclear what course of evaluation to take when a pregnancy test is positive. We describe the clinical course of a patient with widely metastatic mucinous ovarian carcinoma with metastasis to the peritoneum, lymph nodes and liver. The patient was found to have a mildly elevated β-hCG during initial evaluation for clinical trial. Extensive work up for ectopic pregnancy, trophoblastic disease, and phantom β-hCG were negative. The patient's β-hCG levels continued to rise until initiation of therapy. She was treated on a phase I protocol with restaging scans revealing a partial response. The β-hCG was retested and declined in conjunction with her response, consistent with paraneoplastic β-hCG. Here, we propose a decision making algorithm to evaluate a patient with an elevated β-hCG undergoing assessment for clinical trial.
KW - Clinical trial
KW - Ovarian cancer
KW - Paraneoplastic syndrome
KW - Phantom hCG
KW - Tumor heterogeneity
KW - β-hCG heterophilic antibody
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U2 - 10.1016/j.gore.2016.05.004
DO - 10.1016/j.gore.2016.05.004
M3 - Article
C2 - 27355002
AN - SCOPUS:84979537028
SN - 2352-8729
VL - 17
SP - 49
EP - 52
JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
ER -