Secretion of hCG/beta-hCG by squamous cell carcinoma of the lung in a 31-year-old female smoker

We describe a rare case of pulmonary squamous cell carcinoma secreting huma n chorionic gonadotropin (hCG) and its beta-subunit (beta-hCG) in a young f emale smoker. A 31-year-old mother of one child had been suffering from dys functional uterine bleeding for about 1 year. Pelvic examinations and abdom inal ultrasonography yielded no abnormal findings and no signs of pregnancy . She developed a pain in the right chest and a huge (12 x 10 cm) squamous cell carcinoma was diagnosed in the right lower lobe. The serum hCG and bet a-hCG levels were high: hCG 5611 mlU/ml (normal upper limit 0.7 mlU/ml), be ta-hCG 12 238 mlU/ml (normal upper limit 0.5 mlU/ml). The patient underwent right lower lobectomy and systematic lymph node dissection. Microscopic st udy showed a poorly differentiated squamous cell carcinoma. The pathologica l stage was T2N0M0, stage IB. Immunohistochemical staining of the tumor was strongly positive for hCG. The serum hCG level returned to normal 1 month after the operation, while an additional 2 months were necessary for the be ta-hCG level to normalize. Dysfunctional uterine bleeding disappeared and t he patient is doing well, with no signs of recurrence, 9 months after the r esection.