Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Spontaneous hemothorax due to hemorrhagic metastatic choriocarcinoma
- Radiologic Findings
- Fig 1-5. Axial images of CT with lung window setting demonstrate multiple ill-defined nodules with halo of ground glass attenuation in the peripheral zones of both lungs. Unenhanced CT scan shows high attenuation in the pleural fluid (higher than 40 H.U) and contrast-enhanced CT image demonstrates contrast material extravasation.
A wedge resection of the left upper lobe was done. The histopathologic diagnosis was gestational trophoblastic tumor, consistent with metastatic choriocarcinoma.
- Brief Review
- Spontaneous hemothorax is an uncommon condition which may be related to malignancies.
The most common cause of spontaneous hemothorax is in association with pneumothorax from the rupture of vascularized adhesions or vascularized bullae. Less common causes of spontaneous hemothorax include coagulopathy, vascular rupture and neoplasm. The most common malignancies associated with spontaneous hemothorax are sarcomas, angiosarcomas, and hepatocellular carcinoma.
Trophoblastic tumors such as choriocarcinoma display three major characteristics of trophoblastic tissue: the tendency to invade blood vessels, rapid proliferation, and rich vascularity. These features account for the hemorrhagic event of metastatic choriocarcinoma such as hemoptysis and hemothorax.
Although choriocarcinoma is often preceded by molar pregnancy, some patients may present with symptoms resulting from metastases without any gynecological symptoms.
- Please refer to
Case 857, Case 204, Case 83, Case 60, -
KSTR Imaging Conference 2005 Summer Case 10,
- References
- 1. Ibi et al. Choriocarcinoma of the lung: report of a case. Gen Thorac Cardiovasc Surg 2012; 60:377-380.
2. Saha K, Basuthakur S, Jash D, Bandyopadhyay A. Gestational choriocarcinoma presenting as hemothorax. Indian J Med Sci 2010;64:237-40.
- Keywords
- Lung, Pleura, Neoplasm, Malignant neoplasm, Metastasis,