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Sarcoma. 2000;4(4):179-81. doi: 10.1080/13577140020025904.

Retroperitoneal Leiomyosarcoma Associated with an Elevated beta-HCG Serum Level Mimicking Extragonadal Germ Cell Tumor.

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  • 1Department of Urology University Clinics ‘Carl Gustav Carus’ Technical University of Dresden Fetscherstrasse 74 Dresden D-01307 Germany.


Patient. A 65-year-old man was admitted with a large primary retroperitoneal tumor and an increased beta-human chorionic gonadotropin (beta-HCG) serum level. A germ cell tumor was suspected; however, a computed tomography-guided biopsy failed to enable tumor classification. After two courses of chemotherapy, the beta-HCG serum level had returned to the normal level and a diagnostic laparotomy with incisional biopsy was performed. The immunohistochemical examination of the specimen identified the tumor as a retroperitoneal pleomorphic leiomyosarcoma.Discussion. Tumor markers play only a marginal role in the work-up of patients with soft tissue sarcomas. In men with suspected retroperitoneal sarcomas, however, the determination of germ cell tumor markers occasionally enables a preoperative distinguishing of primary retroperitoneal germ cell tumors with considerable consequences for management. In this setting, a retroperitoneal tumor associated with a moderately elevated beta-HCG is a diagnostic dilemma, and surgeons should be aware of the pitfall of a beta-HCG-producing leiomyosarcoma in the differential diagnosis.

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