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Annals of Oncology 13:975-977, 2002
© 2002 European Society for Medical Oncology

Clinical Investigations

Sexual precocity and recurrent ß-human chorionic gonadotropin upsurges preceding the diagnosis of a malignant mediastinal germ-cell tumor in a 9-year-old boy

J. Schwabe1, G. Calaminus1, W. Vorhoff2, V. Engelbrecht3, B. P. Hauffa4 and U. Göbel1,+

1Department of Pediatric Hematology and Oncology, 2Department of General Pediatrics, Children’s Hospital and 3Institute of Diagnostic Radiology, Heinrich-Heine-University, Düsseldorf; 4Department of Pediatric Hematology/Oncology and Endocrinology, Children’s Hospital, University of Essen, Germany

Received 7 June 2001; revised 12 September 2001; accepted 24 September 2001.

Abstract

Numerous disorders are known to cause sexual precocity. ß-human chorionic gonadotropin (ß-HCG)-secreting germ-cell tumors are one of the sources that have to be considered in the differential diagnosis of processes inducing a peripheral precocious puberty. Germ-cell tumors might be located in the ovaries or testes, retroperitoneum, mediastinum or the cranium.

We present the case of a 9-year-old boy with sexual precocity and a recurrent transient ß-HCG elevation. After an interval of 2 years with repeated radiological examinations including the mediastinum, a mediastinal tumor was identified by magnetic resonance imaging. To our knowledge, this is the first case of a diagnosis of a mediastinal choriocarcinoma with a recurrent serum ß-HCG elevation. So far, factors that might be responsible for the repeated spontaneous ß-HCG decline are unknown.

Key words: ß-human chorionic gonadotropin elevation, mediastinal choriocarcinoma, sexual precocity


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