Elevated Human Chorionic Gonadotrophin Due to Pancreatic Cancer

Preoperative pregnancy testing is common practice among anesthesiologists. Little is re-ported in anesthesia literature on causes other than pregnancy for elevated human chorionic go-nadotrophin (hCG) levels. Among these causes is hCG secretion by tumors. This is a report of a female with pancreatic cancer that presented for a Whipple procedure, who on routine pregnancy testing was found to have an elevated hCG level. This unexpected result led to significant delay and undue stress for the patient. After determining pregnancy was unlikely and multiple poorly differentiated metastatic masses were discovered, it was decided that the most likely cause of her hCG levels was cancer. Multiple cancers have been reported to secrete hCG, and more specifically β hCG [1]. Studies of elevated hCG in pancreatic cancer patients report an incidence of 40% 56% [2,3]. Serum β hCG testing done prior to the date of surgery (DOS) in cancer patients that are preor perimenopausal should be considered as it would allow time for a more definitive pregnancy evaluation to be performed.