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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.


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a Chest computed tomography shows multiple high-density nodules and patchy infiltrates with a halo sign (arrows) in both lungs. b Several atypical cells (arrow) are scattered in the lung tissue and bronchial mucosa squamous epithelial hyperplasia (hematoxylin and eosin × 200)
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Fig3: a Chest computed tomography shows multiple high-density nodules and patchy infiltrates with a halo sign (arrows) in both lungs. b Several atypical cells (arrow) are scattered in the lung tissue and bronchial mucosa squamous epithelial hyperplasia (hematoxylin and eosin × 200)

Mentions: A 46-year-old Chinese woman of Han nationality was admitted for 5 days because of hemoptysis. She has a son and a daughter, and had had an abortion four times. She had menopause and was positive for a pregnancy test 60 days prior to admission. Five days prior to her admission, she had hemoptysis without obvious causes; the amount of blood was approximately 100 ml per day. She did not have fever, chest pain, or dyspnea. Four days before her admission she had a chest CT scan, and the images showed multiple high-density nodules with a halo sign in both lungs (Fig. 3a). Since the onset of the symptoms, she had normal mental status, diet, sleep, and defecation, and her body weight did not change significantly. A physical examination on admission showed that both her lungs were clear, and rales and pleural friction sound were not heard. Laboratory tests showed an hCG level of 207,900 U/L in her blood. Moreover, bronchoscopy revealed the absence of abnormalities and bleeding. A TBLB was performed in the anterior basal segment of the lower lobe of her right lung. Lung tissue pathology was negative (Fig. 3b). She was diagnosed as having choriocarcinoma based on her hCG level and history.Fig. 3


Hemoptysis as primary manifestation in three women with choriocarcinoma with pulmonary metastasis: a case series
a Chest computed tomography shows multiple high-density nodules and patchy infiltrates with a halo sign (arrows) in both lungs. b Several atypical cells (arrow) are scattered in the lung tissue and bronchial mucosa squamous epithelial hyperplasia (hematoxylin and eosin × 200)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: a Chest computed tomography shows multiple high-density nodules and patchy infiltrates with a halo sign (arrows) in both lungs. b Several atypical cells (arrow) are scattered in the lung tissue and bronchial mucosa squamous epithelial hyperplasia (hematoxylin and eosin × 200)
Mentions: A 46-year-old Chinese woman of Han nationality was admitted for 5 days because of hemoptysis. She has a son and a daughter, and had had an abortion four times. She had menopause and was positive for a pregnancy test 60 days prior to admission. Five days prior to her admission, she had hemoptysis without obvious causes; the amount of blood was approximately 100 ml per day. She did not have fever, chest pain, or dyspnea. Four days before her admission she had a chest CT scan, and the images showed multiple high-density nodules with a halo sign in both lungs (Fig. 3a). Since the onset of the symptoms, she had normal mental status, diet, sleep, and defecation, and her body weight did not change significantly. A physical examination on admission showed that both her lungs were clear, and rales and pleural friction sound were not heard. Laboratory tests showed an hCG level of 207,900 U/L in her blood. Moreover, bronchoscopy revealed the absence of abnormalities and bleeding. A TBLB was performed in the anterior basal segment of the lower lobe of her right lung. Lung tissue pathology was negative (Fig. 3b). She was diagnosed as having choriocarcinoma based on her hCG level and history.Fig. 3

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.


Related in: MedlinePlus