Respiratory failure due to choriocarcinoma: A study of 103 dyspneic patients

Pulmonary Metastatic Choriocarcinoma from a Burned-out Testicular Tumor

“…Respiratory failure caused by the pulmonary metastasis of choriocarcinoma can progress rapidly. In a previous report, 11% of the patients with the pulmonary metastasis of choriocarcinoma who presented with dyspnea died within one month of the start of therapy (14). As our patient quickly progressed to respiratory failure and, as a result, we were not able to administer the recommended chemotherapy.…”

Acute cardiopulmonary failure in a young woman with high-risk gestational trophoblastic neoplasia: A case of induction chemotherapy during extracorporeal membrane oxygenation

“…When her hypoxia increased despite lung-protective ventilation and permissive hypercarbia, ECMO was initiated. Early use of ECMO in GTN with pulmonary lesions has been recommended as a treatment consideration ( Kelly et al, 1990 , Montrief et al, 2020 ), as positive pressure ventilation in patients with pulmonary tumor burden can lead to barotrauma and pulmonary hemorrhage ( Kelly et al, 1990 ). Our patient stabilized quickly once ECMO was initiated.…”

“…GTN is most often diagnosed following abnormal pregnancies, persistent vaginal bleeding, or an increasing or plateau in beta-human chorionic gonadotropin (HCG) levels, but cases of respiratory symptoms alone as the presenting symptom have been reported ( Kelly et al, 1990 , Staples et al, 2019 , Multani et al, 2015 ). For example, Kelly et al described 135 patients over a 28 year period whose initial complaint was shortness of breath ( Kelly et al, 1990 ). Staples et al reported on two patients treated with video assisted thoracoscopic surgery for lung mass and lung nodule, one of whom presented with chest tightness and dyspnea ( Staples et al, 2019 ).…”

Choriocarcinoma in an AIDS patient – relapsing but not fatal

“…GTD has been reported as fatal in patients with concomitant AIDS. 2,4 Moreover, respiratory failure requiring mechanical ventilation due to metastatic GTD in immunocompetent patients typically carries a very high mortality rate 5 , with survival reported only in one patient. 3 In two retrospective case series 6,7 , patients characterized by >50% chest X-ray opacification, hCG > 10 5 , anaemia and chest pain were particularly susceptible to early respiratory death despite mechanical ventilation.…”

“…In vitro studies have suggested that HIV replication might be inhibited by the b-subunit of hCG. 8,9 Hence, we questioned whether the occurrence of GTD and an extremely elevated b-hCG level in this HIV-positive patient could affect the course of her HIV infection. In this case, we report high HIV viral counts despite markedly elevated b-hCG levels, during a time period when this patient was not receiving HAART (Figure 4).…”