hCG can be other things

17 Oct

JUST TO MAKE YOU THINK:

non-benign case report of a false-postive (sort of) urine pregnancy test:

HIGHLIGHTS:

  • 46 yo F presents with sudden L thigh pain s/p GLF (right knee sprain last week, using crutches)
  • XR showed mid-shaft femur fx
  • urine hCG (routine?) was positive
  • quantitative serum hCG 308 mIU/mL
  • pelvic ultrasound negative
  • pt denied sexual activity in past few months (how often have we heard this?)
  • 30 yr smoking hx
  • CT scan & biopsy confirmed lung CA (adenocarcinoma)
  • femur fx likely pathalogic from met

THINGS THAT PRODUCE beta-hCG (some less commonly than others):

  • pregnancy
  • pregnancy
  • pregnancy
  • hydatiform moles
  • choriocarcinoma
  • germ cell tumors (ovarian, testicular, intracranial, mediastinal)
  • GI cancers (biliary, pancreatic, gastric, hepatocellular, colorectal)
  • gyn cancers (ovarian, cervical, vulvovaginal)
  • urologic cancer (bladder, renal, prostate)
  • breast cancer
  • head/neck squamous cell CA
  • meningiomas
  • lymphomas
  • sarcomas
  • lung cancer (“most common non-gestational malignancy associated with bhCG production”)

 

 

References: Maughan BC, Kamat A.  Lung carcinoma presenting with pathologic femur fracture and false-positive pregnancy test result.  Ann Emerg Med. 2012 Sep;60(3):378-80. Epub 2012 Mar 15.; picture 

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