A 25-year old man with bilateral gynecomastia and multiple metastatic tumor nodules in both lung fields would most likely have primary cancer of the?
Bone marrow
Testicle
Kidney
Islets cells of the pancreas.
This patient most likely has metastasis from a choriocarcinoma originating in his testicles.13-Human chorionic gonadotropin (j3-hCG) is released from the syncytiotrophoblast poion of the tumor. The gynecomastia most likely results from stimulation of breast tissue by the 3-hCG, which is a luteinizing hormone (LH) analog. Leukemias or multiple myeloma originating from the bone marrow are not associated with gynecomastia. Kidney tumors, especially renal adenocarcinoma, can ectopically secrete gonadotropins; however, renal tumors do not usually occur in patients this young. Islet cell tumors of the pancreas do not ectopically secrete 13-hCG or gonadotropins. Most anterior pituitary tumors are benign. Primary gonadotropinsecreting tumors are rare.