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Case Reports
. 2021 Mar 31:36:100762.
doi: 10.1016/j.gore.2021.100762. eCollection 2021 May.

Pulmonary metastasis as a primary manifestation of gestational choriocarcinoma in a third trimester pregnancy

Ahmad Arabi  1 , Martins Ayoola-Adeola  1 , Huy Q Nguyen  2 , Harpreet Brar  3 , Christopher Walker  1
Affiliations
Case Reports

Pulmonary metastasis as a primary manifestation of gestational choriocarcinoma in a third trimester pregnancy

Ahmad Arabi et al. Gynecol Oncol Rep. .

Abstract

•Choriocarcinomas can follow molar, ectopic, or normal pregnancies.•The early diagnosis and treatment of choriocarcinomas is imperative.•Atypical symptoms in pregnancy should raise suspicion for choriocarcinoma.•Choriocarcinoma must always be in the differential in uncomplicated term pregnancies.

Keywords: Choriocarcinoma; Gestational trophoblastic disease; Hemoptysis; Invasive mole; Molar pregnancy; Neoplasm; Placenta; Term pregnancy; Third trimester; Trophoblasts.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
CT scan of the thorax. Innumerable bilateral pulmonary masses (arrows). The masses are mostly spherical, are confluent, and have a random distribution. The masses do not demonstrate cavitation or calcification. No pleural effusion or pneumothorax.
Fig. 2
Fig. 2
Histopathology showing lymphovascular invasion by the tumor cells. (A) Areas of hemorrhage and necrosis (asterisk) surrounding by malignant cells (40X). (B) The tumor cells show marked nuclear pleomorphism, hyperchromasia and atypia (arrows) (200X). (C) The tumor cells surround (arrows) and invade (arrow head) the blood vessels (200X). (D) Tumor cells are strongly positive for hCG immunohistochemical stain (arrow).
Fig. 3
Fig. 3
Choriocarcinoma with metastases to the liver, spleen and brain. (A) CT of the abdomen showing hypoattenuating lesion in the right lobe of the liver (arrow). (B) CT of the abdomen showing hypoattenuating lesion in the most anterior aspect of the spleen (arrow). (C) MRI of the Brain showing hyperintensities in the bilateral parieto-occipital cortex demonstrated by T2-weighted images.
See this image and copyright information in PMC

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