Angiographic Demonstration of Arteriovenous Shunts in Pulmonary Metastatic Choriocarcinoma

Green, James D.; Carden, Terrence S.; Hammond, Charles B.; Johnsrude, Irwin S.

doi:10.1148/108.1.67

Cited by 18 publications

(11 citation statements)

References 3 publications

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“…GTT metastases at other anatomical sites may also be highly vascular and have the potential to form AVMs that can lead to life-threatening haemorrhage [6,7]. In this current case a patient with low-risk post-molar pregnancy GTT developed haemoptysis during methotrexate chemotherapy and imaging investigations demonstrated an AVM in her left lung.…”

Section: Discussionmentioning

confidence: 74%

“…The most common site of metastasis in GTT are the lungs, but the formation of AVMs at this or any other extra-uterine site of spread has only been recorded rarely [6,7]. This case reviews the diagnosis of a pulmonary AVM (pAVM) in a patient with GTT and occult lung metastases successfully treated with radiological embolisation and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Haemoptysis from a pulmonary arteriovenous malformation in a post molar pregnancy gestational trophoblast tumour patient managed by radiological embolisation: a case report

et al. 2014

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IntroductionGestational trophoblastic tumours are a rare form of malignancy, which in the majority of cases arise from abnormal trophoblast cells formed in a complete molar pregnancy. These tumours are extremely sensitive to chemotherapy and high cure rates approaching 100% can be expected. The disease is usually limited to the uterus where the abnormal trophoblast proliferation and human chorionic production can lead to vascular changes including the formation of arteriovenous malformations.Case presentationWe describe the case of a 28-year-old Caucasian woman who presented to the United Kingdom's Gestational Trophoblast Tumour Service with rising human chorionic gonadotropin levels following a uterine evacuation for a complete molar pregnancy. She was commenced on chemotherapy but subsequently reported two episodes of haemoptysis. Computed tomography imaging demonstrated findings consistent with a pulmonary arteriovenous malformation, probably due to a small pulmonary metastasis, complicated by recent haemorrhage. These findings were confirmed on emergency pulmonary arteriography, and the pulmonary arteriovenous malformation was successfully embolised.ConclusionsArteriovenous malformations secondary to gestational trophoblastic tumours at metastatic sites have only been reported in a very limited number of cases. When significant bleeding occurs, as in this case of a pulmonary lesion, urgent referral for embolisation is indicated.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Haemoptysis from a pulmonary arteriovenous malformation in a post molar pregnancy gestational trophoblast tumour patient managed by radiological embolisation: a case report

et al. 2014

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“…The lung is the most common site of metastatic disease [ 1 ], usually characterized by multiple rounded, hypervascular soft tissue density nodules, which can show surrounding ground-glass opacities (“halo sign”) on CT images reflecting alveolar hemorrhage due to the high vascularity of the lesions [ 3 , 4 ]. It is also well documented that gestational trophoblastic diseases are associated with the development of uterine arteriovenous malformation [ 5 ], but the formation of arteriovenous shunts at another extrauterine site of spread, such as the lung, has been rarely reported [ 6 , 7 , 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Acquired Pulmonary Arteriovenous Fistula within Metastasis from Choriocarcinoma: A Case Report

et al. 2017

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Choriocarcinoma is a highly malignant neoplasm arising from the trophoblast of a human pregnancy, which may have distant spread to multiple organs, particularly to the lung. We report a case of a pulmonary arteriovenous fistula that developed after chemotherapy within a choriocarcinoma metastasis. A 24-year-old female with a history of uterine choriocarcinoma presented with multiple hypervascular pulmonary nodules on the initial chest computed tomography (CT) scan, consistent with lung metastases. Four months after chemotherapy, follow-up chest CT revealed a decrease in the size and vascularity of the lung metastases, except for 1 nodule that persisted with marked contrast enhancement and developed a communication with a pulmonary artery and vein. These findings were consistent with an acquired arteriovenous fistula. Physicians should be aware of the risk of acquired arteriovenous fistula in pulmonary metastases after chemotherapy because it can lead to a right-to-left shunt, pulmonary hemorrhage, and paradoxical emboli. It is also important for the definition of therapeutic planning, in order to avoid it being misdiagnosed as a site of disease progression.

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“…Angiographic studies have shown that pulmonary metastases of GTD are hyper-vascular tumors, and are supplied by the pulmonary artery (6). Pulmonary AVMs are abnormally dilated vessels which provide an anatomic rightto-left shunt between the pulmonary artery and the pulmonary vein without an intervening pulmonary capillary system (7).…”

Section: Discussionmentioning

confidence: 99%

Accompanying Pulmonary Arteriovenous Malformation in Patient with Hydatidiform Mole: A Case Report

Bak

Yoon

Jeon

et al. 2017

J Korean Soc Radiol

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Angiographic Demonstration of Arteriovenous Shunts in Pulmonary Metastatic Choriocarcinoma

Cited by 18 publications

References 3 publications

Haemoptysis from a pulmonary arteriovenous malformation in a post molar pregnancy gestational trophoblast tumour patient managed by radiological embolisation: a case report

Haemoptysis from a pulmonary arteriovenous malformation in a post molar pregnancy gestational trophoblast tumour patient managed by radiological embolisation: a case report

Acquired Pulmonary Arteriovenous Fistula within Metastasis from Choriocarcinoma: A Case Report

Accompanying Pulmonary Arteriovenous Malformation in Patient with Hydatidiform Mole: A Case Report

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