Hemoptysis as the first symptom in the diagnosis of metastatic choriocarcinoma in the third trimester of pregnancy: A case report

• Published in: Case reports in women's health Vol. 27; p. e00211
• Main Authors: Álvarez-Sarrado, Leticia, González-Ballano, Isabel, Herrero-Serrano, Rebeca, Giménez-Molina, Claudia, Rodríguez-Solanilla, Belén, Campillos-Maza, José-Manuel
• Format: Report
• Language: English
• Published: 01.07.2020
• DOI: 10.1016/j.crwh.2020.e00211

INTRODUCTIONChoriocarcinoma is a rare neoplasm (1/40000 pregnancies). In the context of a viable pregnancy, the incidence is even lower (1/160000). CASE REPORTA woman in her second pregnancy was admitted at 31 + 6 weeks of gestation with hemoptysis and abnormal vaginal bleeding. Numerous placental venous lakes, bilateral pulmonary nodules and a pleural effusion were found. Pleural fluid β-HCG levels were elevated and a brain-chest-abdominal-pelvic CT scan led to the diagnosis of a high-risk gestational trophoblastic neoplasm. A caesarean section at 32 + 1 weeks of gestation was performed. Six cycles of an EMA-CO chemotherapy regime were administered. β-HCG levels normalized after 3 cycles. Placental histopathology confirmed the presence of a gestational choriocarcinoma. CONCLUSIONChoriocarcinoma is a highly aggressive tumor. In high-risk tumors, combination chemotherapy is the first-line treatment, offering high remission rates. Treatment response is evaluated by monitoring blood β-HCG levels, which should be long-term.