Reactions 1341 - 5 Mar 2011

SAntineoplastics

Increased serum hCG and tuberculosis?: casereport

A 36-year-old woman developed increased serumhuman chorionic gonadotrophin (hCG) levels andtuberculosis during chemotherapy [routes not stated].

The woman, who was hospitalised with an advancedovarian germ cell tumour, received two days ofchemotherapy with etoposide 100 mg/m2 and cisplatin20 mg/m2 [dosage details incomplete], and then herchemotherapy regimen was switched to the POMB/ACEcombination* [dosage details not stated]. She wasdischarged for outpatient chemotherapy after 1 month, butpresented with impaired consciousness and pyrexia2 weeks after discharge.

The woman started receiving empirical treatment forneutropaenic sepsis, viral encephalitis and tuberculosis.Two days later, her condition further deteriorated and shedeveloped meningism and nystagmus. An MRI revealedoedema and a number of enhancing lesions. She continuedto receive empiric therapy and her condition graduallyimproved over the next 10 days. A CSF sample was foundto be positive for tuberculosis. POMB/ACE chemotherapywas recommenced, but she developed elevated levels ofhCG. She was diagnosed with CNS tuberculosis. ThePOMB/ACE chemotherapy was stopped after a total of16 weeks and she received 6 months’ anti-tuberculosistherapy. Her hCG eventually returned to normal and herCNS lesions essentially resolved.

* The POMB/ACE combination normally consists of cisplatin,vincristine, methotrexate, bleomycin, dactinomycin,cyclophosphamide and etoposide.

Rakha S, et al. Pituitary hCG production and cerebral tuberculosis mimickingdisease progression during chemotherapy for an advanced ovarian germ celltumour. BMC Cancer 10: 338, 2010 - England 803050362

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Reactions 5 Mar 2011 No. 13410114-9954/10/1341-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved