Human chorionic gonadotropin and malignant mesothelioma

Our plain-English summary of Human chorionic gonadotropin and malignant mesothelioma, by S. Rich, C.A. Presant, J. Meyer, et al (Cancer, 1979).

The study

• Authors: S. Rich, C.A. Presant, J. Meyer, S.C. Stevens, D. Carr
• Journal: Cancer
• Published: 1979;43(4):1457-62
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy.

Abstract

A 56-year-old male presented with ascites and gynecomastia. Laparoscopy demonstrated peritoneal tumors which were biopsied. Conventional histology and electron microscopy revealed the tumor to be a malignant mesothelioma. The ascitic fluid and tumor cell lysate, but not serum, contained hCG by specific assay, and the immunoreactive hCG had characteristics similar to purified hCG in filtration on Sephadex G-100. Malignant mesothelioma is a tumor which may be associated with elevated hCG concentrations. Demonstration of hCG in ascitic fluid should suggest the presence of neoplasm.

In plain English

This was a case report about one patient. A 56-year-old black man came to The Jewish Hospital of St. Louis in December 1976 with abdominal fluid (ascites) and enlarged breasts. He said his job had included handling asbestos fibers for 6 years, starting 25 years before his symptoms; no fiber type was named. Biopsies confirmed malignant mesothelioma of the peritoneum (the abdominal lining), and his chest X-rays showed no pleural masses. The authors tested for the hormone human chorionic gonadotropin (hCG) using an assay for its beta subunit. Two samples of his abdominal fluid contained 7.6 and 12.0 mIU/ml, and a lysate of his tumor cells contained 7.7 mIU per mg protein. His blood had less than 0.4 mIU/ml, which is normal for men. Fluid from one patient with cirrhosis had none detectable. He died in August 1977 despite treatment. The authors wrote that their findings in this patient suggest mesothelioma tumor cells can make and secrete hCG. They judged it possible but unlikely that the cells had only stored it, and they called for further studies.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 56-year-old black male patient seen at The Jewish Hospital of St. Louis, Missouri, in December 1976, with ascites and gynecomastia (breast enlargement)
• Exposure: By the patient's own account, his occupation included handling asbestos fibers for 6 years, beginning 25 years before his symptoms began. The fiber type was not specified.
• Main results:
  • Tissue examination by light and electron microscopy showed features of epithelial mesothelioma on the peritoneal surface. Chest X-rays were normal, with no pleural masses.
  • The first ascitic fluid sample from the patient contained 7.6 mIU/ml (9.7 ng/ml) of the beta subunit of hCG, or 3.93 mIU per mg protein.
  • The second ascitic fluid sample from the patient contained 12.0 mIU/ml (15.3 ng/ml), or 6.3 mIU/mg protein.
  • Serum samples taken from the patient at the same times showed less than 0.4 mIU/ml on each occasion, which the authors describe as normal for males by this method.
  • Ascitic fluid from one patient with hepatic cirrhosis contained no detectable beta-hCG.
  • A lysate of the patient's neoplastic cells contained 7.7 mIU beta-hCG per mg protein.
  • On gel filtration, the protein in the patient's ascitic fluid behaved similarly to normal hCG.
  • The S-phase fraction of the patient's tumor was 12.4%, which the authors say indicates a high rate of DNA synthesis.
  • The patient was treated with intraperitoneal radioactive phosphorus (32P) and chemotherapy, and died in August 1977.
• The authors' conclusion: The authors wrote that their observations in this patient suggest that tumor cells in malignant mesothelioma can synthesize and secrete hCG. They considered uptake and storage, rather than synthesis, possible but unlikely. They also suggested that hCG in ascitic fluid could potentially indicate a cancer cause of the ascites.
• Limitations the authors state:
  • The authors note it is possible, though they consider it unlikely, that the hCG found in the tumor cell lysate reflected uptake and storage rather than synthesis by the tumor.
  • The authors state that a prospective trial is needed to document how often beta-hCG occurs in patients with ascites from cancer and from benign causes.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Ascites, Histology, Neoplasm.

Related studies

• Recombinant human endostatin (endostar) decreased recurrent ascites, pleural fluid and ascitic VEGF in a case of advanced mesothelioma — X. Chen, Y. Liu, et al. (2012)
• Diagnostic problems in serous effusions — C.W. Bedrossian (1998)
• Use of antisera to epithelial membrane antigen for the cytodiagnosis of malignancy in serous effusions — A. To, D.V. Coleman, et al. (1981)
• Detection of cancer cells in effusions from patients diagnosed with gynaecological malignancies. Evaluation of five epithelial markers — B. Davidson, B. Risberg, et al. (1999)
• Calretinin. A selective marker of normal and neoplastic mesothelial cells in serous effusions — M.C. Barberis, M. Faleri, et al. (1997)
• Diagnostic usefulness of EMA, IMP3, and GLUT-1 for the immunocytochemical distinction of malignant cells from reactive mesothelial cells in effusion cytology using cytospin preparations — K. Ikeda, G. Tate, et al. (2011)

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