Large cell carcinoma of the lung secreting human chorionic gonadotropin which responded to combination chemotherapy: case report.

A 68-year-old man was admitted to the National Cancer Center Hospital on November 10, 1988 to undergo chemotherapy for recurrent lung cancer, which had been resected on June 22, 1988. The tumor was diagnosed histologically as large cell carcinoma with trophoblastic differentiation, and human chorionic gonadotropin (HCG) was immunohistochemically found in tumor cells. Chemotherapy was initiated on November 14, 1988. The patient received three courses of methotrexate, actinomycin D and cyclophosphamide (MAC); and two courses of cisplatin and etoposide (PVP). Following this therapy, partial response was achieved, however, the tumor soon progressed and the serum HCG level increased to 7,571 mIU/ml. The patient was consequently given four courses of cisplatin, adriamycin, cyclophosphamide and etoposide (PACE) up to September 13, 1989, and received 52 Gy irradiation to the chest from July 20 to August 24. The tumor regressed markedly and the serum HCG decreased to within normal limits. The changes in serum HCG levels in serial samples correlated well with the clinical tumor burden. The patient is now in partial remission having survived for more than 15 months after the initiation of chemotherapy.