Choriocarcinoma of the Thymus

Choriocarcinoma is a notorious, highly malignant tumor of placental or teratoid testicular origin. An obscure entity referred to as "primary extragenital chorionepithelioma of the mediastinum" is described herewith as choriocarcinoma of the thymus. The fact that this neoplasm occurs almost exclusively in young men is substantiated by similar sequences iterated in 43 reports in the literature. A typical case is presented of a 26-year-old man whose fatal 2-month course was epitomized by hemoptysis, dyspnea, pain, gynecomastia, testicular atrophy, and positive tests for chorionic gonadotropin. Effective treatment for choriocarcinoma was wanting until a few years ago. This radioresistant tumor has responded to a folic acid antagonist, and to combinations of an antimetabolite, an alkylating agent, and the antitumor antibiotic actinomycin D. These approaches to the therapy of choriocarcinoma, however, appear to be less satisfactory in men than in women.