Background: Testicular choriocarcinoma is a scarce type of non-seminomatous germ cell tumor and it often occurs in young males. It is the most aggressive form of germ cell tumor and tends to spread hematogenously, especially to the lungs. Pneumothorax is rarely the first manifestation of lung metastasis. Case summary: This case report describes a 33-year-old male with testicular choriocarcinoma and pulmonary metastasis, who presented with pneumothorax as the first critical manifestation. To the best of our knowledge, this is the second report of its kind in the literature. Conclusion: Spontaneous pneumothorax should be considered as the first serious clinical manifestation in patients with germ cell tumors.
Key words: Choriocarcinoma, Lung metastasis, spontaneous pneumothorax, testicular malignancy
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