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Case Report

A Rare Case of Choriocarcinomatous Pulmonary Embolism revealed by Ischemic Strokes

Sami El Himri, Mohamed Labied, Ghizlane Lembarki, Mouna Sabiri, Samia El Manjra, Samira Lezar, Fatiha Essodegui.

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Choriocarcinoma is a malignant tumor with high metastatic potential belonging to the spectrum of gestational trophoblastic tumors, which can be of germ cell origin (nongestational) or gestational. Choriocarcinomatous pulmonary embolism represents a rare and aggressive extra-gonadal form of gestational trophoblastic disease, most often occurring after a normal or pathological pregnancy. The presentation is similar to that of cruoric embolism, but it is characterized by local invasion and significant hematogenous dissemination leading to distant metastases. Increased Human chorionic gonadotropin hormone (hCG) levels are suggestive of the diagnosis. We report a case of choriocarcinomatous pulmonary embolism involving the inferior lobar artery of the left lung in a 44-year-old female patient admitted for multiple ischemic strokes. The diagnosis of choriocarcinoma was done on CT scan in the presence of high levels of Human chorionic gonadotropin hormone (hCG) contrasting with negative pelvic imaging and a history of previous spontaneous abortion. The outcome was favourable after chemotherapy which was an additional argument in favor of the diagnosis of choriocarcinoma.

Key words: Pulmonary embolism, Choriocarcinoma, Ischemic strokes, Human chorionic gonadotropin hormone (hCG)

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