Non-Traumatic Massive Hemothorax Caused by a Hydatidiform Mole: A Case Report and Review of the Literature

Abstract

Gestational trophoblastic diseases (GTDs) include the complete and partial hydatidiform mole (benign GTDs), invasive mole, placental site trophoblastic tumor, and choriocarcinoma (malignant GTDs). GTDs, both benign and malignant, have the potential of distant metastases. The lung is the most common site of metastases. When GTDs metastasize to the lungs, there are three principal radiologic patterns, i.e. discrete pulmonary nodules, multiple small pulmonary opacities, and pictures mimicking pulmonary embolism. Most patients are asymptomatic clinically, but some may present symptoms such as dyspnea, chest pain, cough and hemoptysis. Only a few cases of GTDs with hemothoraces have been reported in the literature. Choriocarcinoma accounted for most of those cases, and not hydatidiform moles. Herein, we present a case of hydatidiform mole, a benign GTD, with subpleural lung metastasis, and a subsequent rare manifestation of hemothorax. Based on our report, hydatidiform moles with subpleural lung involvement should be considered as one of the etiologies in the clinical differential diagnosis for non-traumatic hemothorax.