K. De Geest

Metastatic choriocarcinoma to the lung coexistent with a viable pregnancy

A 31-year-old G4P2 at 33weeks gestation was transferred from a local hospital for persistent cough and a right hemothorax. Her obstetric history was significant for two uncomplicated vaginal deliveries at term, followed by a spontaneous abortion 6months prior to the current pregnancy. Significant labs included an elevated BHCG of 118,946. A CTscan of the chest showedmultiple lung nodules without hilar adenopathy. The pulmonary service performed a diagnostic bronchoscopy, which was unsuccessful in making a diagnosis secondary to the peripheral location of the pulmonary nodules. Approximately 12days after initial presentation, the patient underwent cervical mediastinoscopy, revealing negative mediastinal lymph nodes. Right