Solitary lung metastasis from gestational choriocarcinoma resected six years after hydatidiform mole: A case report

INTRODUCTION: Recently, the opportunity to encounter lung metastasis from choriocarcinoma has become very rare for thoracic surgeons, since chemotherapy works very well and the operative indications for lung metastasis are limited. PRESENTATION OF CASE: A 45-year-old woman with a past history of hydatidiform mole six years previously was found to have a nodulous chest shadow in the right middle lung field on a chest radiography. She was also suspected of having an ovarian tumor and underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. No malignancy was detected in the ovaries or uterus. A thoracoscopic partial pulmonary resection was then performed for the right lower lung nodule. The pathological diagnosis was choriocarcinoma. Her preoperative serum beta-human chorionic gonadotropin value was high (482.8 mIU/mL). Thus, she was diagnosed as having a pulmonary metastasis from gestational choriocarcinoma arising six years after a complete hydatidiform mole. DISCUSSION: The possibility of choriocarcinoma arising as a solitary lung tumor should be considered regardless of the interval from the preceding molar pregnancy. The patient’s medical history and high concentration of β-hCG in preoperative residual serum were helpful in arriving at a diagnosis of metastatic gestational CCA. CONCLUSION: We presented pulmonary metastasectomy for very unique and rare metastatic choriocarcinoma arising six years after hydatidiform mole.