Choriocarcinomatous neoplastic pulmonary embolism. A case

Abstract Massive obstruction of the right branches of the pulmonary artery by choriocarcinomatous cells was found at embolectomy in a 36 year old woman who had had a hydatidiform mole 10 years previously. Several febrile lung infections resistant to antibiotic therapy over an 11 months period, had led to a reduction in the volume and vascularisation of the right lung. The diagnosis of recurrent pulmonary embolism was only suspected when a further embolic episode occurred after curettage for a spontaneous abortion at 9 weeks of pregnancy. The diagnostic value of increased HCG was masked by the pregnancy. The patient died a few days after surgery despite administration of chemotherapy postoperatively. The authors discuss the problems in the diagnosis of recurrent pulmonary embolism in the absence of a suggestive cause and the problem of detecting the tumoural nature of these emboli.