Choriocarcinoma of The Fallopian TubeCoincident with Viable Pregnancy

Abstract

A case is reported in which a choriocarcinoma of the Fallopian tube coexisted with a living fetus Addendum.—The patient continued to do well until Nov. 16, 1954, when, on repeat x-ray survey, a 5 cm. density was found in the lower lobe of the right lung. A serum gonadotrophin assay was positive in a 1 to 10 dilution. On November 21 she experienced a paroxysm of coughing which was accompanied by hemoptysis, dyspnea, and pain in the right chest. X-ray confirmed the physical findings of a right pleural effusion. Thoracentesis abated the symptoms. The fluid was positive for tumor cells. On November 30 the patient was given 12.6 mg. of nitrogen mustard intravenously. She responded well as evidenced by a dramatic clinical improvement, the leukocyte response, and negative hormone titers. From December 10 to December 30, she received as an outpatient a total dose of 3,200 r over the anterior and posterior right chest. Because of upper abdominal and right chest pain, she was readmitted on Jan. 3, 1955. On January 7, 10 mg. more of nitrogen mustard was given. Despite her subjective improvement, she became more cachectic and died on January 31, five and one-half months after her first admission. Autopsy disclosed extensive metastases to the liver, lungs, and adrenal glands. A case is reported in which a choriocarcinoma of the Fallopian tube coexisted with a living fetus Addendum.—The patient continued to do well until Nov. 16, 1954, when, on repeat x-ray survey, a 5 cm. density was found in the lower lobe of the right lung. A serum gonadotrophin assay was positive in a 1 to 10 dilution. On November 21 she experienced a paroxysm of coughing which was accompanied by hemoptysis, dyspnea, and pain in the right chest. X-ray confirmed the physical findings of a right pleural effusion. Thoracentesis abated the symptoms. The fluid was positive for tumor cells. On November 30 the patient was given 12.6 mg. of nitrogen mustard intravenously. She responded well as evidenced by a dramatic clinical improvement, the leukocyte response, and negative hormone titers. From December 10 to December 30, she received as an outpatient a total dose of 3,200 r over the anterior and posterior right chest. Because of upper abdominal and right chest pain, she was readmitted on Jan. 3, 1955. On January 7, 10 mg. more of nitrogen mustard was given. Despite her subjective improvement, she became more cachectic and died on January 31, five and one-half months after her first admission. Autopsy disclosed extensive metastases to the liver, lungs, and adrenal glands.