# Primary mediastinal choriocarcinoma requiring differentiation from non-small cell lung cancer: An autopsy case report

## TL;DR

A rare case of primary mediastinal choriocarcinoma was diagnosed postmortem, highlighting the difficulty in distinguishing it from lung cancer.

## Contribution

Highlights the importance of considering choriocarcinoma in undifferentiated lung/mediastinal tumors through β-hCG testing.

## Key findings

- Primary mediastinal choriocarcinoma is rare and often misdiagnosed as lung cancer.
- Rapid deterioration and poor prognosis are common in undiagnosed cases.
- Serum β-human chorionic gonadotropin levels can aid in diagnosis.

## Abstract

A 65-year-old man with dyspnea and hemoptysis presented with a right upper lobe mass associated with enlarged mediastinal lymph nodes and bilateral pulmonary nodules on chest computed tomography (CT), suspected lung cancer. Bronchial and CT-guided biopsies revealed poorly differentiated carcinoma. His condition deteriorated rapidly before a definitive diagnosis could be made. Autopsy revealed primary mediastinal choriocarcinoma. Primary mediastinal choriocarcinomas are rare, difficult to diagnose early and have a poor prognosis. In patients with a tumor expanding across the lung and mediastinum and exhibiting pathologic findings of a pooly differentiated carcinoma, we should consider choriocarcinoma, evaluating the serum β-human chorionic gonadotropin levels.