Ovarian vein thrombosis as a first manifestation of COVID-19 infection.

Coronavirus disease 2019 (COVID-19) infection is associated with high risk of venous thromboembolic events mainly pulmonary embolism or deep venous thrombosis of the lower limbs. Ovarian vein thrombosis is a rare and serious condition usually seen in the immediate postpartum period and other conditions including pelvic inflammatory diseases, gynecological malignancies, hypercoagulable states, and few cases to date have reported ovarian vein thrombosis as a complication of COVID-19 infection. Patient with ovarian vein thrombosis usually presents with fever and lower abdominal pain that can mimic acute surgical abdomen and high index of suspicion is required for diagnosis. We report a case of a 41-year-old Asian female presented to our hospital with fever and acute lower abdominal pain. Laboratory findings show positive COVID-19 test and high D-dimer. Patient underwent computed tomography of the abdomen and pelvis and a confirmed diagnosis of right ovarian vein thrombosis was made. Patient was treated with anticoagulation and empirical antibiotics and her symptoms have significantly improved.

Pure testicular choriocarcinoma Cannonball metastases as a presenting imaging feature: A case report and a review of literature.

Pure testicular choriocarcinoma is an extremely rare subtype of nonseminomatous germ cell tumor, accounting for less than 1% of all germ cell tumors and only 0.19% of all testicular tumors. It is a highly aggressive malignant tumor with early multiorgan metastasis and poor prognosis. We present a case of 23-year-old male presented to the hospital with mild hemoptysis which was thought as a sequela of his past COVID-19 pneumonia infection, however; chest radiograph showed multiple rounded cannonball opacities seen throughout both lungs raising the suspicion of metastatic deposits to the lungs. During physical examination, left testicular painless swelling was noted leading to an ultrasound of the scrotum which revealed a left intratesticular infiltrative, heterogeneous mass. Tumor markers, including beta-human chorionic gonadotropin, lactate dehydrogenase and alpha fetoprotein were extremely high. Computed tomography scan of the brain, chest, abdomen, and pelvis showed hemorrhagic metastatic deposits to the brain, chest, and left para-aortic lymph nodes. The patient underwent radical orchiectomy and histopathology reports confirmed the diagnosis of pure testicular choriocarcinoma.