Case Reports in Oncology最新文献

{"title":"Glioblastoma beyond the Brain: A Case Series Demonstrating Systemic Metastatic Potential.","authors":"Nidal Salim, Kristina Tumanova, Ilya Loyko, Mikhail Travin","doi":"10.1159/000553017","DOIUrl":"10.1159/000553017","url":null,"abstract":"<p><strong>Introduction: </strong>Glioblastoma (GBM) is an aggressive primary brain tumor that rarely metastasizes outside the central nervous system, with reported rates of extracranial dissemination below 2%. Increasing survival and improved diagnostic capabilities may contribute to more frequent detection of this phenomenon.</p><p><strong>Case presentation: </strong>We describe a retrospective case series of 3 consecutive patients with histopathologically confirmed IDH-wild-type GBM who developed extracranial metastases at our institution. Clinical, radiological, pathological, and molecular data were extracted from medical records. Histopathological confirmation of metastatic disease was achieved in 2 of three patients, and an independent second-opinion pathology review was obtained for 1 case. Patient 1 (55-year-old man) developed cervical lymph node metastasis within 6 months of initial resection despite <i>MGMT</i> promoter methylation; the recurrent tumor contained a primitive neuroectodermal tumor-like component, immunophenotypically supported by diffuse Ki-67 positivity (∼100%) and expression of synaptophysin, chromogranin, CD56, and NSE. Patient 2 (56-year-old man) developed rapid systemic dissemination to bone, lung, liver, and the interatrial septum approximately 18 months after diagnosis; the metastatic tumor displayed mesenchymal (gliosarcoma-like) differentiation with co-expression of GFAP, SMA, and h-caldesmon, PD-L1 SP263 CPS 10/TPS 10%, retained mismatch-repair proteins, and a clinically significant <i>TP53</i> c.833C>G (p.Pro278Arg) mutation identified by NGS. Patient 3 (48-year-old woman) survived 61 months despite unfavorable molecular markers, with late leptomeningeal and multiorgan dissemination. Overall survival was 8, 22, and 61 months for patients 1, 2 and 3, respectively.</p><p><strong>Conclusions: </strong>This series illustrates three distinct biological trajectories of extracranial GBM dissemination and supports the concept that prolonged survival, repeated surgical interventions, and specific molecular features (mesenchymal differentiation, PD-L1 expression, <i>TP53</i> mutation) may unmask systemic metastatic potential in IDH-wild-type GBM. Clinicians should maintain a high index of suspicion for extracranial dissemination in long-term GBM survivors and in patients with atypical systemic symptoms; targeted use of whole-body 18F-FDG PET/CT and histopathological confirmation of suspicious lesions are essential for accurate diagnosis.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1087-1099"},"PeriodicalIF":0.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Ductal Adenocarcinoma with Atypical Genomic Profile: A Case of Long-Term Survival with <i>KRAS</i>-Wildtype, Microsatellite Instability and High Tumor Mutational Burden.","authors":"Gaby J Strijk, Michail C Doukas, Bjorn Lohman, Anja Wagner, Johanna W Wilmink, Casper H J van Eijck","doi":"10.1159/000552404","DOIUrl":"10.1159/000552404","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive malignancies, typically associated with late-stage diagnosis and limited survival despite advances in systemic therapy. Long-term survival in metastatic PDAC is exceedingly rare, and treatment strategies are limited by the intrinsic resistance of the tumor to standard therapies. However, emerging evidence suggests that molecular subtypes may exhibit distinct biological behaviors and may be amenable to new therapeutic options.</p><p><strong>Case presentation: </strong>We report the remarkable long-term survival of a 43-year-old male with a blank medical history, diagnosed with metastatic PDAC in 2018. The patient presented with postprandial upper abdominal discomfort that progressed to obstructive jaundice, leading to the discovery of a pancreatic head mass with metastatic lymphadenopathy. Despite the poor prognosis typically associated with metastatic PDAC, the patient achieved significant disease control through FOLFIRINOX chemotherapy and underwent surgical resection following complications from vascular involvement. Next-generation sequencing (NGS) revealed a rare <i>KRAS</i>-wildtype tumor with microsatellite instability (MSI) and a high tumor mutational burden (TMB). Moreover, a long-standing suspicion of Lynch syndrome could finally be confirmed.</p><p><strong>Conclusion: </strong>This case highlights the potential impact of personalized treatment and molecular tumor profiling in reshaping the outlook for PDAC patients.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1045-1054"},"PeriodicalIF":0.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Euglycemic Diabetic Ketoacidosis under Empagliflozin during Neoadjuvant Pembrolizumab and Chemotherapy in Early Breast Cancer: A Case-Report.","authors":"Emmanuelle Alaluf, Dana Chat, Amit Itay, Tehillah Menes, Tal Sella, Maya Dadiani, Einav Nili Gal-Yam, Ruth Percik","doi":"10.1159/000552506","DOIUrl":"10.1159/000552506","url":null,"abstract":"<p><strong>Introduction: </strong>Empagliflozin is a widely used medication for type 2 diabetes mellitus (T2DM) that can increase the risk for diabetic ketoacidosis (DKA) among susceptible patients. Pembrolizumab cancer immunotherapy can lead to immune-related adverse events such as diabetes mellitus (DM), with most of the reported cases presenting with hyperglycemic DKA. However, euglycemic DKA (eDKA) can also occur and is particularly dangerous because of the potential for delayed or misdiagnosis of DKA.</p><p><strong>Case presentation: </strong>We report a breast cancer patient with DM receiving empagliflozin and basal insulin therapy, presenting with eDKA during neoadjuvant chemotherapy and pembrolizumab immunotherapy. The patient's condition deteriorated into a comatose state, which necessitated intubation and mechanical ventilation. She improved under intravenous fluids and insulin, returned to full consciousness, was extubated and discharged from the intensive care unit. She underwent surgery and radiotherapy and was most recently seen in the oncology unit with an excellent performance status again.</p><p><strong>Conclusion: </strong>To the best of our knowledge, we report the first case of fulminant eDKA in a breast cancer patient treated with empagliflozin, neoadjuvant chemotherapy and pembrolizumab immunotherapy according to the Keynote 522 regimen, despite basal insulin therapy initiation, highlighting the need to use this combination with caution.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1074-1080"},"PeriodicalIF":0.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenchyma-Sparing Bronchial Sleeve Resection for Central Typical Endobronchial Pulmonary Carcinoid in a Young Adult: A Case Report.","authors":"Mohammad Alaa Aldakak, Wasfi Sahloul, Bassel Ibrahim, Yamama Abo Dakka, Hamza Alhallaq, Anas Abdulrazzak, Youness Souleiman","doi":"10.1159/000552990","DOIUrl":"10.1159/000552990","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary carcinoid tumors are uncommon neuroendocrine neoplasms. Central endobronchial lesions may cause obstruction, hemoptysis, recurrent infection, and asthma-like symptoms. Surgery aims for complete resection while preserving functional lung parenchyma when feasible.</p><p><strong>Case presentation: </strong>A 26-year-old male smoker presented with an 8-month history of chronic cough, recurrent small-volume hemoptysis, and exertional dyspnea. Chest CT suggested a central right endobronchial lesion. Flexible bronchoscopy showed a smooth polypoid mass obstructing the bronchus intermedius. Bronchial lavage grew <i>Enterobacter</i> species, likely representing secondary post-obstructive colonization or infection, and targeted antibiotics were given. Biopsies confirmed typical carcinoid, supported by synaptophysin positivity and low Ki-67 index. Preoperative testing showed an obstructive spirometric pattern and acceptable blood gas parameter. The patient underwent right posterolateral thoracotomy with bronchial sleeve resection, primary end-to-end anastomosis, and pleural flap reinforcement. Margins were negative, and the postoperative course was uneventful with full lung expansion. This case highlights the value of CT and bronchoscopy, and illustrates how sleeve resection can achieve complete tumor removal while avoiding more extensive lung resection in a young patient.</p><p><strong>Conclusion: </strong>Bronchial sleeve resection is an effective parenchyma-sparing option for selected central endobronchial carcinoids, especially when lung preservation is clinically important.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1012-1020"},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleural Pseudomyxoma Secondary to Appendiceal Mucinous Adenocarcinoma: A Case Report.","authors":"Mohammad Hossein Teymoori, Alireza Gandomi-Mohammadabadi, Alireza Ramezani, Nasrin Asgari Soran, Masoud Maleki, Massoud Baghai Wadji","doi":"10.1159/000552854","DOIUrl":"10.1159/000552854","url":null,"abstract":"<p><strong>Introduction: </strong>Appendiceal mucinous neoplasms are uncommon gastrointestinal tumors. In some cases, they evolve into pseudomyxoma peritonei (PMP), a condition characterized by mucinous ascites and peritoneal dissemination. Treatment typically requires comprehensive cytoreductive surgery (CRS), commonly combined with hyperthermic intraperitoneal chemotherapy (HIPEC). While PMP usually remains confined to the abdominal cavity, extra-abdominal spread is exceptional. Pleural involvement, often described as pleural pseudomyxoma, has been reported only rarely.</p><p><strong>Case presentation: </strong>We report the case of a 55-year-old man who was initially diagnosed with PMP arising from a well-differentiated mucin-producing adenocarcinoma of the appendix. He underwent CRS with splenectomy without HIPEC because of financial and technical limitations. Approximately 1 year later, he developed progressive dyspnea and cough. Imaging revealed left pleural effusion with nodular pleural thickening and mucinous densities. Video-assisted thoracoscopic surgery demonstrated mucinous pleural deposits, and histopathological examination confirmed metastatic well-differentiated mucinous adenocarcinoma involving the pleura. He underwent thoracoscopic pleural debulking followed by systemic chemotherapy, with short-term disease stability.</p><p><strong>Conclusion: </strong>Pleural pseudomyxoma represents an exceedingly rare thoracic extension of appendiceal PMP. Although CRS-HIPEC remains the preferred treatment strategy for selected patients in specialized centers, individualized thoracoscopic debulking combined with systemic chemotherapy may provide short- to intermediate-term disease control in resource-limited settings.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1021-1028"},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Stable Disease in an Adult with Malignant Gastrointestinal Tumor following Cabozantinib Treatment: Case Report.","authors":"Brianna Jo Iverson, Mohammed M Milhem, John Markus Rieth","doi":"10.1159/000552857","DOIUrl":"10.1159/000552857","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant gastrointestinal neuroectodermal tumor (GNET) is a rare and aggressive neoplasm that is characterized by EWSR1 rearrangements. Most patients present with metastatic disease. There are no established treatment guidelines, and systemic therapy options remain poorly defined.</p><p><strong>Case presentation: </strong>A woman in her late 30s presented initially with right upper quadrant pain and bloating. Endoscopic biopsy of a duodenal mass revealed a SOX10-positive malignant neoplasm. Molecular testing identified an EWSR1:CREB1 fusion, confirming GNET. Initial treatment with ipilimumab and nivolumab resulted in disease progression. Subsequent therapies included a selective interleukin-2 agonist clinical trial, nivolumab/relatlimab, and temozolomide, all associated with continued progression. Cabozantinib was initiated after further radiographic progression. Follow-up imaging demonstrated tumor regression, and the patient maintained stable disease for 15 months before mild progression.</p><p><strong>Conclusion: </strong>Metastatic GNET has a poor prognosis and lacks standardized systemic therapy. This case demonstrates durable disease stabilization with cabozantinib after progression on immunotherapy and chemotherapy. Tyrosine kinase inhibition may represent a promising therapeutic strategy in GNET and warrants further investigation.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"984-988"},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Undifferentiated Embryonal Sarcoma of the Liver with Spontaneous Tumor Rupture and Comprehensive Molecular Profiling: A Case Report.","authors":"Deepika Beereddy, Durga Naga Malleswara Rao Jonnalagadda, Pratap Tetali, Bing Han","doi":"10.1159/000552992","DOIUrl":"10.1159/000552992","url":null,"abstract":"<p><strong>Introduction: </strong>Undifferentiated embryonal sarcoma of the liver (UESL) is an aggressive malignant mesenchymal neoplasm that occurs predominantly in children and is exceptionally rare in adults. Adult UESL carries a significantly worse prognosis, with 5-year overall survival of approximately 30-48%, and no standardized treatment protocol exists.</p><p><strong>Case presentation: </strong>A 44-year-old woman presented with progressively worsening abdominal pain. Cross-sectional imaging revealed a large cystic hepatic mass initially suspected to represent biliary cystadenoma, cystadenocarcinoma, complex hepatic cyst, or abscess. She underwent left lateral hepatectomy, with intraoperative findings notable for a 17-cm tumor with intralesional hemorrhage, vascular involvement, and intraoperatively confirmed spontaneous tumor rupture into the peritoneal cavity. Histopathologic examination confirmed high-grade undifferentiated embryonal sarcoma with negative surgical margins. The patient received five cycles of adjuvant doxorubicin, ifosfamide, and mesna, which were discontinued due to cumulative chemotherapy-induced anemia and fatigue. Comprehensive molecular profiling identified CDKN2B deletion, MAGE-A4 positivity (2+, 80%), low tumor mutational burden, microsatellite-stable status, equivocal genomic loss of heterozygosity, and predicted HLA-A*02:01 positivity with no other actionable genomic alterations. Surveillance imaging at 6 months demonstrated no evidence of recurrence.</p><p><strong>Conclusion: </strong>Clinicians and radiologists should maintain a high index of suspicion for UESL when evaluating large cystic hepatic lesions in adults, as diagnostic misclassification is common. This case highlights the prognostic significance of spontaneous tumor rupture and demonstrates that molecular profiling can identify biologically relevant alterations - including MAGE-A4 expression - that could inform future investigational approaches. Collaborative multi-institutional efforts are needed to establish standardized treatment protocols for this rare malignancy.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1035-1044"},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Divergent Responses to Enfortumab Vedotin and Pembrolizumab in Concurrent Urothelial and Renal Cell Carcinoma: Case Report and Literature Review.","authors":"Zane N Gray, Qi Cai, Richard W Ahn, Yair Lotan, Jue Wang","doi":"10.1159/000552939","DOIUrl":"10.1159/000552939","url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy, particularly immune checkpoint inhibitors (ICIs), has revolutionized the treatment of metastatic urothelial carcinoma (UC) and renal cell carcinoma (RCC). However, these cancers may exhibit divergent responses to the same immunotherapy.</p><p><strong>Case presentation: </strong>Here, we report a case of a patient with concurrent stage 4 UC and resected stage III clear cell RCC (ccRCC) who experienced complete remission of UC following treatment with enfortumab vedotin (EV) and pembrolizumab but developed hyperprogression of metastatic RCC. The decision was made to discontinue ICIs and initiate a combination therapy of lenvatinib (VEGF receptor inhibitor) and everolimus (mTOR inhibitor). The patient exhibited a complete radiographic response to this combination therapy, with no significant side effects, and has remained well 18 months after the onset of hyperprogression in ccRCC.</p><p><strong>Conclusion: </strong>We highlight the role of distinct immune microenvironments in mediating differential responses to immunotherapy, in patients with coexisting UC and ccRCC. We underscore the importance of personalized treatment strategies in patients with dual malignancies, particularly when divergent responses to immunotherapy are observed, offering durable responses while avoiding the risks associated with continued immune checkpoint inhibition.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1055-1065"},"PeriodicalIF":0.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare and Life-Threatening Case of Giant Cell Tumor of Bone: Massive Posterior Rib Origin Causing Airway Obstruction.","authors":"Yuka Iijima, Naofumi Asano, Kota Watanabe, Takahiro Suzuki, Keisuke Asakura, Yuki Aibara, Sayaka Iwai Yamaguchi, Tomoaki Mori, Robert Nakayama, Masaya Nakamura","doi":"10.1159/000552856","DOIUrl":"10.1159/000552856","url":null,"abstract":"<p><strong>Introduction: </strong>Primary giant cell tumor of bone (GCTB) of the rib is rare. Herein, we report a rare case of posterior rib GCTB causing airway compression.</p><p><strong>Case presentation: </strong>A 35-year-old woman complained of back pain and dyspnea for 4 months. A bone tumor in the posterior fifth rib was suspected, and needle biopsy confirmed the diagnosis of GCTB. The tumor occupied the right thoracic cavity, compressing the main bronchus and extensively invading the vertebral body. Because complete resection was initially considered infeasible, an airway stent was placed, and denosumab therapy was initiated. However, dyspnea recurred; therefore, complete surgical resection was subsequently performed in two stages: intrathoracic and chest wall part. During the initial surgery, extracorporeal membrane oxygenation support was prepared because of the anticipated high-risk airway, and awake bronchoscopic intubation was performed with the patient in the sitting position. Postoperatively, denosumab therapy was continued, and no recurrence was observed during 60 months of follow-up.</p><p><strong>Conclusion: </strong>Posterior rib GCTB with airway compression is extremely rare and may be difficult to control with denosumab alone. In the present case, favorable long-term local control was achieved through a combination of surgical resection and denosumab therapy.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"959-968"},"PeriodicalIF":0.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Extragonadal Choriocarcinoma Presenting with Pneumothorax in an Elderly Male Patient: A Case Report.","authors":"Hiroshi Shintani, Naoki Kataoka","doi":"10.1159/000552847","DOIUrl":"10.1159/000552847","url":null,"abstract":"<p><strong>Introduction: </strong>Non-gestational choriocarcinoma is an extremely rare and highly aggressive trophoblastic malignancy in male patients. It frequently presents with multiorgan metastases and poor prognosis. Spontaneous pneumothorax associated with metastatic pulmonary tumors is uncommon and may indicate rapid tumor progression. Here, we report a rare case of primary extragonadal choriocarcinoma presenting with pneumothorax in an elderly male patient.</p><p><strong>Case presentation: </strong>An 80-year-old man presented with cough and dyspnea. Chest computed tomography revealed right pneumothorax, more than 30 bilateral pulmonary nodules, mediastinal lymphadenopathy, and hepatic lesions. Persistent air leakage required thoracoscopic surgery. Histopathological examination of the resected lung specimen demonstrated hemorrhagic and necrotic nodules with biphasic trophoblastic morphology. Immunohistochemistry was positive for GATA binding protein 3, human chorionic gonadotropin, and CK7, leading to the diagnosis of choriocarcinoma. The serum human chorionic gonadotropin level was markedly elevated at 17,000 mIU/mL. Positron emission tomography/computed tomography revealed no abnormalities in the testes, and the tumor was considered most consistent with primary extragonadal choriocarcinoma. Despite temporary postoperative improvement, the disease progressed rapidly and the patient died on hospitalization day 24.</p><p><strong>Conclusion: </strong>This rare case highlights that choriocarcinoma should be considered in the differential diagnosis of pneumothorax accompanied by multiple pulmonary nodules, even in elderly male patients. Pneumothorax occurring before treatment may reflect highly aggressive tumor behavior, emphasizing the importance of early pathological diagnosis and prompt clinical intervention.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"943-949"},"PeriodicalIF":0.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}