[Hemoptysis revealing an endobronchial metastasis of testicular choriocarcinoma]

Abstract

The choriocarcinoma are neoplasms developed from testicular germ cells in men or fetal trophoblasts in women. The most common sites for metastatis are in the lung, but the endobronchial location is unusual. We report the case of a young patient of 27 years, hospitalized for hemoptysis of moderate volume, occurring in the context of deterioration in his general condition. The radiological assessment revealed an opacity of the right lung and bronchoscopy showed a highly vascularized middle lobe stenosis with biopsy confirming the diagnosis of choriocarcinoma. Urogenital examination found an enlarged left testicle and ultrasound confirmed a tumor-like expansive process with no liver or spleen involvement. HCG levels were high. The patient underwent a left orchiectomy via inguinal, pathological and immunohistochemical study confirmed the diagnosis of testicular choriocarcinoma. The patient received three cycles of chemotherapy based on the BEP with good tolerability. This has allowed chemotherapy, despite endobronchial metastasis, to achieve remission of good quality. The frequency of atypical choriocarcinoma metastases is very low, and treatment is mainly based on chemotherapy.