ABSTRACT
Choriocarcinoma is a highly malignant neoplasm arising from the trophoblast of a human pregnancy, which may have distant spread to multiple organs, particularly to the lung. We report a case of a pulmonary arteriovenous fistula that developed after chemotherapy within a choriocarcinoma metastasis. A 24-year-old female with a history of uterine choriocarcinoma presented with multiple hypervascular pulmonary nodules on the initial chest computed tomography (CT) scan, consistent with lung metastases. Four months after chemotherapy, follow-up chest CT revealed a decrease in the size and vascularity of the lung metastases, except for 1 nodule that persisted with marked contrast enhancement and developed a communication with a pulmonary artery and vein. These findings were consistent with an acquired arteriovenous fistula. Physicians should be aware of the risk of acquired arteriovenous fistula in pulmonary metastases after chemotherapy because it can lead to a right-to-left shunt, pulmonary hemorrhage, and paradoxical emboli. It is also important for the definition of therapeutic planning, in order to avoid it being misdiagnosed as a site of disease progression.
ABSTRACT
We report a case of intrapericardial teratoma, which is a rare primary cardiac tumor usually found in newborns and infants. Cardiac teratomas can cause respiratory failure, large accumulations of pericardial fluid and cardiac compression leading to death in the intrauterine or neonatal period. The case described is rare because it is of a 16-year-old asymptomatic girl with an intrapericardial tumor as an incidental echocardiographic finding. Cardiac magnetic resonance imaging showed a complex pericardial cyst. Due to the potential for malignant evolution, she was referred for surgery to remove the tumor and a diagnosis of teratoma was confirmed by histopathology. Clinical follow-up had a good outcome.
