Disseminated gestational choriocarcinoma presenting with hepatic and uveal metastases, hook effect, and choriocarcinoma syndrome

Aswani, Yashant; Thakkar, Hemangini; Hira, Priya

doi:10.4103/0971-3026.195781

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…As bleeding becomes more extensive, patchy ground-glass opacities may be depicted throughout the lung, a finding consistent with diffuse alveolar hemorrhage (25,26,29). Hemothorax has also been reported (28). In the liver, hemorrhagic metastases can lead to subcapsular hematoma and hemoperitoneum (Fig 4a) (27).…”

Section: Choriocarcinoma Syndromementioning

confidence: 74%

“…Choriocarcinoma syndrome is defined as extensive bleeding of choriocarcinoma metastases, which can lead to diffuse alveolar hemorrhage in the lungs and subcapsular hematoma in the liver (26,27). Severe cases of choriocarcinoma syndrome may result in disseminated intravascular coagulation, massive hemorrhage, and shock (25)(26)(27)(28).…”

Section: Choriocarcinoma Syndromementioning

confidence: 99%

“…The typical imaging findings associated with choriocarcinoma syndrome are dependent on In some cases, metastases may produce pseudoaneurysms or arteriovenous fistulas (Fig 4a, 4b) (28,30). Catheter angiograms will depict tumor vascularity and, in some cases, pseudoaneurysms that may require urgent catheter-directed embolization to manage associated hemorrhage (Fig 4c).…”

Section: Choriocarcinoma Syndromementioning

confidence: 99%

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Unusual Imaging Findings Associated with Germ Cell Tumors

et al. 2019

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Germ cell tumors, because they contain immature and mature elements, can differentiate into different tissue types. They can exhibit unusual imaging features or manifest in a syndromic fashion. The authors describe these features and assign them to one of the following categories: (a) unusual manifestations of metastatic disease (growing teratoma syndrome, choriocarcinoma syndrome, ossified metastases, and gliomatosis peritonei); (b) autoimmune manifestations (sarcoidlike reaction and paraneoplastic syndromes); (c) endocrine syndromes (sex hormone production, struma ovarii, and struma carcinoid); or (d) miscellaneous conditions (ruptured dermoid cyst, squamous cell carcinoma arising from a mature teratoma, Currarino triad, fetus in fetu, pseudo-Meigs syndrome, and pancreatitis). Rare conditions associated with germ cell tumors demonstrate characteristic imaging findings that can help lead to the appropriate diagnosis and management recommendations. When evaluating for potential metastatic disease, alternative benign diagnoses should be considered (eg, growing teratoma syndrome, ossified metastases, ruptured dermoid cyst, gliomatosis peritonei, and sarcoidlike reaction), which may impact management. Germ cell tumors may also lead to life-threatening complications such as extensive hemorrhage from choriocarcinoma metastases or the rupture of mature teratomas, cases in which timely diagnosis is crucial. Autoimmune and endocrine manifestations such as paraneoplastic encephalitis, autoimmune hemolytic anemia, and hyperthyroidism may occur owing to the presence of germ cell tumors and can create a diagnostic dilemma for clinicians. Knowledge of the syndromic and unusual imaging findings associated with germ cell tumors helps guide appropriate management. ©

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Section: Choriocarcinoma Syndromementioning

confidence: 74%

Section: Choriocarcinoma Syndromementioning

confidence: 99%

Section: Choriocarcinoma Syndromementioning

confidence: 99%

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Unusual Imaging Findings Associated with Germ Cell Tumors

et al. 2019

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“…[ 14 ] In some cases, metastases may produce pseudoaneurysm or arteriovenous fistulas, which differential diagnosis from renal cell carcinoma, thyroid carcinoma, angiosarcoma, or hemangioendothelioma. [ 15 ] Childbearing history and rising β-HCG could help to identify the disease. Nowadays deoxyribonucleic acid geno-typing using polymerase chain reaction to analyze short-tandem repeat polymorphism has emerged as a powerful tool in the precise diagnosis and classification of GTDs.…”

Section: Discussionmentioning

confidence: 99%

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

Liu

Sun

et al. 2023

Medicine

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Rationale: Choriocarcinoma is a highly invasive gestational trophoblastic neoplasm, usually metastasis to lung and brain, but occurrence of choriocarcinoma following spontaneous abortion presenting as a vertebral tumor is extremely rare, to the best of our knowledge. Because of the poor diagnosis and high malignancy, the low progression-free survival follows up. Patient concerns: We here are reporting a case of choriocarcinoma that presented with vertebral tumor induced paralysis of limbs and incontinence of urine. Diagnosis: Combined with the childbearing history, high β-human chorionic gonadotrophinin levels, and imaging examination, a clinical diagnosis was made exactly. Till the pathological results after the operation of lumbar spinal canal tumorectomy, the diagnosis was exactly clear. Interventions: After performing the laminectomy, the fierce bleeding follows up, just did the temporary limited decompression. Because of the vertebral artery embolization, lumbar spinal canal tumorectomy, spinal canal and root canal decompression, subdural decompression and hematoma removal were performed. Outcomes: After performing the operation and chemotherapy timely and positively, the patient lost consciousness and died due to the pulmonary embolism at last. Lessons: This is the first case report describing choriocarcinoma with metastases to the spine amongst Chinese population as well. Early metastasis is one of the marked tendencies of choriocarcinoma, but spine metastasis and the related spinal oppressional symptoms were found instead of vaginal bleeding in this case, which is indeed rare.

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“…Our study includes a literature review of CS cases published from 2012 to 2021. These cases are included in Table 1 [4,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The patients with clinical data in the publications were aged from 8 to 64 years.…”

Section: Discussionmentioning

confidence: 99%

Choriocarcinoma syndrome of primary pulmonary choriocarcinoma after lung lobe resection: A case report and review of the literature

Chen

Liu

et al. 2022

Preprint

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Introduction: Primary pulmonary choriocarcinoma (PPC) is extremely rare, especially in males. It is characterized by a poor response to therapy and shortened survival times. Here, we report a PPC case that was complicated by choriocarcinoma syndrome (CS) and present a review of the literature. Case presentation: A 59-year-old man with a 30-pack-year smoking history was referred to our hospital because of haemoptysis and chest pain. Positron emission tomography-computed tomography (PET-CT) showed multiple bilateral pulmonary nodules and multiple metastases throughout the body. The patient underwent single-port thoracoscopic wedge resection of the right lung upper lobe. Histological examinations verified the diagnosis of choriocarcinoma. Three days after the operation, the patient developed massive haemoptysis. A bronchoscopic examination showed bleeding from the bilateral main bronchus. Despite management in the intensive care unit (ICU), the patient died two weeks after surgery. Conclusions For advanced choriocarcinoma cases, minimally invasive or even non-invasive procedures are more suitable to avoid inducing CS. When patients with a high tumour mass and elevated tumour markers, we need to be alert to the occurrence of CS. Surgery and modified chemotherapy, based on the physical condition of the patient, may currently be the best therapy for PPC.

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Disseminated gestational choriocarcinoma presenting with hepatic and uveal metastases, hook effect, and choriocarcinoma syndrome

Cited by 6 publications

References 7 publications

Unusual Imaging Findings Associated with Germ Cell Tumors

Unusual Imaging Findings Associated with Germ Cell Tumors

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

Choriocarcinoma syndrome of primary pulmonary choriocarcinoma after lung lobe resection: A case report and review of the literature

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