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Hemoptysis as primary manifestation in three women with choriocarcinoma with pulmonary metastasis: a case series

View Article: PubMed Central - PubMed

ABSTRACT

Background: Gestational choriocarcinoma is the most common gestational trophoblastic neoplasia; it is often secondary to hydatidiform mole, as well as to abortion, ectopic pregnancy, premature delivery, or term delivery. Approximately 60% of patients with choriocarcinoma develop pulmonary metastases, but for patients with a respiratory condition, choriocarcinoma with lung metastasis is a relatively rare lung cancer diagnosis. Three cases of choriocarcinoma with pulmonary metastasis who had the primary symptom of hemoptysis are described.

Case presentation: This case report describes a 35-year-old Chinese woman of Han nationality, a 23-year-old Chinese woman of Han nationality, and a 46-year-old Chinese woman of Han nationality whose primary symptom was hemoptysis and different chest imaging manifestations; they were finally diagnosed as having pulmonary metastatic choriocarcinoma. All patients had low risk factors, including abortion, hydatidiform mole, and ectopic pregnancy. Human chorionic gonadotropin played an important role in choriocarcinoma diagnosis.

Conclusions: Based on the diagnosis and treatment of the three patients, we suggested that for women with pregnancy history and hemoptysis (particularly in the presence of risk factors such as abortion, hydatidiform mole, ectopic pregnancy, and >35-years old), choriocarcinoma may be the possible diagnosis or at least the main differential diagnosis.

No MeSH data available.


a Chest computed tomography shows multiple clear boundary nodules (arrows) with different sizes in the bilateral lung. b Lung tissue specimen shows necrotic tissue (hematoxylin and eosin × 200)
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Fig2: a Chest computed tomography shows multiple clear boundary nodules (arrows) with different sizes in the bilateral lung. b Lung tissue specimen shows necrotic tissue (hematoxylin and eosin × 200)

Mentions: A 23-year-old Chinese woman of Han nationality complained about coughing blood for 7 days. One week before admission, she had a cold and coughed with blood. Fever, chest tightness and pain, and dyspnea were not reported. Chest CT images revealed multiple nodules of different sizes in both lungs, which could be diagnosed as lung metastasis (Fig. 2a). For further diagnosis and treatment, she was referred to our department. Since the onset of symptoms, she had normal mental status, diet, sleep, and defecation, and her body weight did not change significantly. She had a history of a mole and she underwent curettage 2 months prior to her admission. A physical examination on admission showed that both her lungs were clear, and rales and pleural friction sound were not heard. Her blood hCG was 7500 U/L. She underwent CT-guided percutaneous lung puncture; lung tissue pathology showed necrotic tissue (Fig. 2b). She was diagnosed as having choriocarcinoma.Fig. 2


Hemoptysis as primary manifestation in three women with choriocarcinoma with pulmonary metastasis: a case series
a Chest computed tomography shows multiple clear boundary nodules (arrows) with different sizes in the bilateral lung. b Lung tissue specimen shows necrotic tissue (hematoxylin and eosin × 200)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5392385&req=5

Fig2: a Chest computed tomography shows multiple clear boundary nodules (arrows) with different sizes in the bilateral lung. b Lung tissue specimen shows necrotic tissue (hematoxylin and eosin × 200)
Mentions: A 23-year-old Chinese woman of Han nationality complained about coughing blood for 7 days. One week before admission, she had a cold and coughed with blood. Fever, chest tightness and pain, and dyspnea were not reported. Chest CT images revealed multiple nodules of different sizes in both lungs, which could be diagnosed as lung metastasis (Fig. 2a). For further diagnosis and treatment, she was referred to our department. Since the onset of symptoms, she had normal mental status, diet, sleep, and defecation, and her body weight did not change significantly. She had a history of a mole and she underwent curettage 2 months prior to her admission. A physical examination on admission showed that both her lungs were clear, and rales and pleural friction sound were not heard. Her blood hCG was 7500 U/L. She underwent CT-guided percutaneous lung puncture; lung tissue pathology showed necrotic tissue (Fig. 2b). She was diagnosed as having choriocarcinoma.Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: Gestational choriocarcinoma is the most common gestational trophoblastic neoplasia; it is often secondary to hydatidiform mole, as well as to abortion, ectopic pregnancy, premature delivery, or term delivery. Approximately 60% of patients with choriocarcinoma develop pulmonary metastases, but for patients with a respiratory condition, choriocarcinoma with lung metastasis is a relatively rare lung cancer diagnosis. Three cases of choriocarcinoma with pulmonary metastasis who had the primary symptom of hemoptysis are described.

Case presentation: This case report describes a 35-year-old Chinese woman of Han nationality, a 23-year-old Chinese woman of Han nationality, and a 46-year-old Chinese woman of Han nationality whose primary symptom was hemoptysis and different chest imaging manifestations; they were finally diagnosed as having pulmonary metastatic choriocarcinoma. All patients had low risk factors, including abortion, hydatidiform mole, and ectopic pregnancy. Human chorionic gonadotropin played an important role in choriocarcinoma diagnosis.

Conclusions: Based on the diagnosis and treatment of the three patients, we suggested that for women with pregnancy history and hemoptysis (particularly in the presence of risk factors such as abortion, hydatidiform mole, ectopic pregnancy, and >35-years old), choriocarcinoma may be the possible diagnosis or at least the main differential diagnosis.

No MeSH data available.